Impact of epidural anesthesia on the outcome of elderly patients with endometrial cancer - results of a propensity score matched analysis.

IF 2 4区医学 Q3 ONCOLOGY

Oncology Research and Treatment Pub Date : 2025-02-25 DOI:10.1159/000543540

Valerie Catherine Linz, Marco Johannes Battista, Regina Hummel, Markus Schepers, Eva-Verena Griemert, Mona Wanda Schmidt, Marcus Schmidt, Annette Hasenburg, Katharina Gillen

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引用次数: 0

Abstract

Introduction: Epidural anesthesia is a standard procedure to mitigate pain during surgery for endometrial cancer (EC). Little data exist about the influence of epidural anesthesia on the oncological outcome in elderly patients with EC. This retrospective study aims to investigate potential correlations between epidural anesthesia and cancer recurrence in patients with EC.

Methods: We screened the medical records of patients ≥ 60 years treated surgically for EC at the University Medical Center Mainz between January 2008 and December 2019. All women underwent general anesthesia (GA) alone or combined with epidural anesthesia (EGA). Cox regression, the Kaplan-Meier method and propensity score matching were used to analyze the prognostic influence of the anesthesiologic regime on survival.

Results: A total of 152 women with EC were included. 29 patients (19.1%) formed the EGA cohort. The median time of follow-up (FU) was 31 months [interquartile range (IQR): 8-67.5]. The EGA cohort showed more in-hospital complications (27.6 vs. 8.9%; p=0.006), especially thromboembolic events (3 vs. 0 events; p=0.006), as well as a longer hospital stay (11 (IQR: 8-13) vs. 7 (IQR: 4-9) days; p <0.001). 26 patients (17.1%) developed a recurrence in the follow-up at a median of 13 months [IQR: 7.75-29.5]. 32 patients died during FU (21.1%). The EGA cohort showed higher FIGO stages and a higher histological grading than the GA cohort. In Kaplan-Meier analysis, EGA showed a significantly reduced 5-year recurrence-free survival (RFS) (36.5% vs. 72.6%, p<0.001) and overall survival (OS) (58.6% vs. 79.9%, p=0.008). However, in multivariate Cox regression analysis including FIGO stages and histological grading, EGA did not influence RFS (HR: 2.02; 95%-CI [0.99-4.12], p=0.054), and OS (HR: 1.03; 95%-CI [0.40-2.66], p=0.951). This was backed up by the propensity score matched analysis for survival (RFS: p=0.604, OS: p=0.86).

Conclusion: Considering risk factors, epidural anesthesia in combination with GA did not differ in recurrence-free and overall survival compared to GA. Prospective randomized trials are warranted in order to further evaluate this topic.

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来源期刊

Oncology Research and Treatment ONCOLOGY-

CiteScore

3.20

自引率

0.00%

发文量

期刊介绍： With the first issue in 2014, the journal ''Onkologie'' has changed its title to ''Oncology Research and Treatment''. By this change, publisher and editor set the scene for the further development of this interdisciplinary journal. The English title makes it clear that the articles are published in English – a logical step for the journal, which is listed in all relevant international databases. For excellent manuscripts, a ''Fast Track'' was introduced: The review is carried out within 2 weeks; after acceptance the papers are published online within 14 days and immediately released as ''Editor’s Choice'' to provide the authors with maximum visibility of their results. Interesting case reports are published in the section ''Novel Insights from Clinical Practice'' which clearly highlights the scientific advances which the report presents.