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Propofol-based intravenous anesthesia is associated with improved survival outcomes after major cancer surgery: a nationwide cohort study in South Korea
BACKGROUND: The optimal anesthetic technique for cancer surgery remains a controversial issue. This study aimed to examine whether propofol-based total intravenous anesthesia (TIVA) was associated with survival outcomes after major cancer surgery in South Korea and compare its effectiveness with tha...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Korean Society of Anesthesiologists
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10562064/ https://www.ncbi.nlm.nih.gov/pubmed/36824045 http://dx.doi.org/10.4097/kja.22747 |
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author | Oh, Tak Kyu Jo, Hayoung Song, In-Ae |
author_facet | Oh, Tak Kyu Jo, Hayoung Song, In-Ae |
author_sort | Oh, Tak Kyu |
collection | PubMed |
description | BACKGROUND: The optimal anesthetic technique for cancer surgery remains a controversial issue. This study aimed to examine whether propofol-based total intravenous anesthesia (TIVA) was associated with survival outcomes after major cancer surgery in South Korea and compare its effectiveness with that of inhalation anesthesia. METHODS: This nationwide population-based cohort study included adult patients who were admitted to the hospital and underwent major cancer surgery between January 1, 2016, and December 31, 2020. The major cancers included lung, gastric, colorectal, esophageal, small bowel, liver, pancreatic, and bile duct or gallbladder cancers. RESULTS: A total of 253,003 patients who underwent major cancer surgery were included in the analysis. After propensity score (PS) matching, 115,370 patients (57,685 in each group) were included in the final analysis. In the PS-matched cohort, the TIVA group showed 9% (hazard ratio [HR]: 0.91, 95% CI [0.85, 0.98], P = 0.018) and 7% (HR: 0.93, 95% CI [0.89, 0.96], P < 0.001) lower 90-day and one-year mortality rates, respectively, than the inhalation group. In subgroup analyses, the TIVA group showed lower 90-day mortality than the inhalation group in the gastric (HR: 0.86, 95% CI [0.72, 0.97], P = 0.033), colorectal (HR: 0.64, 95% CI [0.56, 0.73], P < 0.001), and pancreatic (HR: 0.76, 95% CI [0.57, 0.94], P = 0.038) cancer surgery groups. CONCLUSIONS: Propofol-based TIVA is associated with better survival outcomes after major cancer surgeries. Moreover, propofol-based TIVA was beneficial in patients who underwent gastric, colorectal, and pancreatic cancer surgeries. |
format | Online Article Text |
id | pubmed-10562064 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Korean Society of Anesthesiologists |
record_format | MEDLINE/PubMed |
spelling | pubmed-105620642023-10-10 Propofol-based intravenous anesthesia is associated with improved survival outcomes after major cancer surgery: a nationwide cohort study in South Korea Oh, Tak Kyu Jo, Hayoung Song, In-Ae Korean J Anesthesiol Clinical Research Article BACKGROUND: The optimal anesthetic technique for cancer surgery remains a controversial issue. This study aimed to examine whether propofol-based total intravenous anesthesia (TIVA) was associated with survival outcomes after major cancer surgery in South Korea and compare its effectiveness with that of inhalation anesthesia. METHODS: This nationwide population-based cohort study included adult patients who were admitted to the hospital and underwent major cancer surgery between January 1, 2016, and December 31, 2020. The major cancers included lung, gastric, colorectal, esophageal, small bowel, liver, pancreatic, and bile duct or gallbladder cancers. RESULTS: A total of 253,003 patients who underwent major cancer surgery were included in the analysis. After propensity score (PS) matching, 115,370 patients (57,685 in each group) were included in the final analysis. In the PS-matched cohort, the TIVA group showed 9% (hazard ratio [HR]: 0.91, 95% CI [0.85, 0.98], P = 0.018) and 7% (HR: 0.93, 95% CI [0.89, 0.96], P < 0.001) lower 90-day and one-year mortality rates, respectively, than the inhalation group. In subgroup analyses, the TIVA group showed lower 90-day mortality than the inhalation group in the gastric (HR: 0.86, 95% CI [0.72, 0.97], P = 0.033), colorectal (HR: 0.64, 95% CI [0.56, 0.73], P < 0.001), and pancreatic (HR: 0.76, 95% CI [0.57, 0.94], P = 0.038) cancer surgery groups. CONCLUSIONS: Propofol-based TIVA is associated with better survival outcomes after major cancer surgeries. Moreover, propofol-based TIVA was beneficial in patients who underwent gastric, colorectal, and pancreatic cancer surgeries. Korean Society of Anesthesiologists 2023-10 2023-02-24 /pmc/articles/PMC10562064/ /pubmed/36824045 http://dx.doi.org/10.4097/kja.22747 Text en Copyright © The Korean Society of Anesthesiologists, 2023 https://creativecommons.org/licenses/by-nc/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) ) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Clinical Research Article Oh, Tak Kyu Jo, Hayoung Song, In-Ae Propofol-based intravenous anesthesia is associated with improved survival outcomes after major cancer surgery: a nationwide cohort study in South Korea |
title | Propofol-based intravenous anesthesia is associated with improved survival outcomes after major cancer surgery: a nationwide cohort study in South Korea |
title_full | Propofol-based intravenous anesthesia is associated with improved survival outcomes after major cancer surgery: a nationwide cohort study in South Korea |
title_fullStr | Propofol-based intravenous anesthesia is associated with improved survival outcomes after major cancer surgery: a nationwide cohort study in South Korea |
title_full_unstemmed | Propofol-based intravenous anesthesia is associated with improved survival outcomes after major cancer surgery: a nationwide cohort study in South Korea |
title_short | Propofol-based intravenous anesthesia is associated with improved survival outcomes after major cancer surgery: a nationwide cohort study in South Korea |
title_sort | propofol-based intravenous anesthesia is associated with improved survival outcomes after major cancer surgery: a nationwide cohort study in south korea |
topic | Clinical Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10562064/ https://www.ncbi.nlm.nih.gov/pubmed/36824045 http://dx.doi.org/10.4097/kja.22747 |
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