Juan P Cata1, Vijaya Gottumukkala2, Dilip Thakar2, Dinesh Keerty2, Rodolfo Gebhardt3, Diane D Liu4. 1. Department of Anesthesiology and Perioperative Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA. Electronic address: jcata@mdanderson.org. 2. Department of Anesthesiology and Perioperative Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA. 3. Department of Pain Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA. 4. Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
Abstract
STUDY OBJECTIVE: To determine whether postoperative epidural analgesia is associated with better recurrence-free survival and overall survival after lung cancer surgery. DESIGN: Retrospective study. SETTING: Academic hospital. MEASUREMENTS: Data of patients with stage 1, stage 2, and stage 3 nonsmall cell lung cancer, who underwent tumor resection surgery, were studied. Patient data were grouped into three different postoperative pain management interventions: intravenous patient-controlled analgesia, patient-controlled epidural analgesia, and their combination. Univariate and multicovariate Cox proportional hazards models were applied to assess the effects of covariates of interest on overall survival and recurrence-free survival. MAIN RESULTS: The type of postoperative analgesia used for patients who underwent surgery for nonsmall cell lung cancer did not affect recurrence-free survival or overall survival. However, certain variables, including age ≥ 65 years, male gender, body mass index ≥ 25 kg/m(2), ASA physical status 4, and the need for preoperative blood transfusions, pneumonectomy, and postoperative radiation, were associated with decreased recurrence-free survival and overall survival. CONCLUSIONS: The type of postoperative analgesia used after surgery for nonsmall cell lung cancer is not associated with better 2-year or 5-year recurrence-free survival or overall survival rates.
STUDY OBJECTIVE: To determine whether postoperative epidural analgesia is associated with better recurrence-free survival and overall survival after lung cancer surgery. DESIGN: Retrospective study. SETTING: Academic hospital. MEASUREMENTS: Data of patients with stage 1, stage 2, and stage 3 nonsmall cell lung cancer, who underwent tumor resection surgery, were studied. Patient data were grouped into three different postoperative pain management interventions: intravenous patient-controlled analgesia, patient-controlled epidural analgesia, and their combination. Univariate and multicovariate Cox proportional hazards models were applied to assess the effects of covariates of interest on overall survival and recurrence-free survival. MAIN RESULTS: The type of postoperative analgesia used for patients who underwent surgery for nonsmall cell lung cancer did not affect recurrence-free survival or overall survival. However, certain variables, including age ≥ 65 years, male gender, body mass index ≥ 25 kg/m(2), ASA physical status 4, and the need for preoperative blood transfusions, pneumonectomy, and postoperative radiation, were associated with decreased recurrence-free survival and overall survival. CONCLUSIONS: The type of postoperative analgesia used after surgery for nonsmall cell lung cancer is not associated with better 2-year or 5-year recurrence-free survival or overall survival rates.
Authors: Juan P Cata; Visesh Keerty; Dinesh Keerty; Lei Feng; Peter H Norman; Vijaya Gottumukkala; John R Mehran; Mitchel Engle Journal: Cancer Med Date: 2014-04-02 Impact factor: 4.452