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Impact of anesthetic factors on prognosis of patients with non-small cell lung cancer after surgery

BACKGROUND: Nowadays, the influence of anesthesia management on the prognosis of cancer patients has been widely concerned. The goal of this study is to assess the association between anesthetic factors and the prognosis of patients with non-small cell lung cancer (NSCLC) after surgery. METHODS: Pat...

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Autores principales: Zhu, Wenzhi, Li, Shuang, Ji, Xinqiang, Tan, Hongyu
Formato: Online Artículo Texto
Lenguaje:English
Publicado: AME Publishing Company 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10586941/
https://www.ncbi.nlm.nih.gov/pubmed/37868870
http://dx.doi.org/10.21037/jtd-22-1812
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author Zhu, Wenzhi
Li, Shuang
Ji, Xinqiang
Tan, Hongyu
author_facet Zhu, Wenzhi
Li, Shuang
Ji, Xinqiang
Tan, Hongyu
author_sort Zhu, Wenzhi
collection PubMed
description BACKGROUND: Nowadays, the influence of anesthesia management on the prognosis of cancer patients has been widely concerned. The goal of this study is to assess the association between anesthetic factors and the prognosis of patients with non-small cell lung cancer (NSCLC) after surgery. METHODS: Patients with NSCLC who underwent surgery from January 1, 2006, to December 31, 2009 were selected. Cox proportional hazards model and Logistic regression analysis model were used to screen the independent predictors of prognosis of patients. The primary endpoint was postoperative overall survival (OS), and the secondary endpoint was postoperative recurrence-free survival (RFS) and postoperative pulmonary complications (PPCs). RESULTS: A total of 588 patients were included into the final analysis. The overall RFS was 4.4 [interquartile range (IQR), 1.1–10.1] years, and the OS was 6.2 (IQR, 2.4–10.2) years. Age ≥60 years, advanced tumor stage, and maximal tumor size >3 cm were associated with shortened survival, whereas high BMI grade, mediastinal lymph node dissection, perioperative fentanyl equivalents >28.2 µg/kg, and high tumor grade were associated with prolonged survival (P<0.05); perioperative glucocorticoid administration delayed recurrence (P<0.05); advanced tumor stage and perioperative fentanyl equivalents >28.2 µg/kg were associated with an increased PPCs risk (P<0.05). CONCLUSIONS: The findings from this study revealed that perioperative anesthetic factors may impact the prognosis of patients with NSCLC after surgery. Perioperative opioid and glucocorticoid exposure were independent predictors for outcomes. However, perioperative fentanyl equivalents over 28.2 µg/kg seemed to be beneficial to OS, but contribute to the occurrence of PPCs.
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spelling pubmed-105869412023-10-21 Impact of anesthetic factors on prognosis of patients with non-small cell lung cancer after surgery Zhu, Wenzhi Li, Shuang Ji, Xinqiang Tan, Hongyu J Thorac Dis Original Article BACKGROUND: Nowadays, the influence of anesthesia management on the prognosis of cancer patients has been widely concerned. The goal of this study is to assess the association between anesthetic factors and the prognosis of patients with non-small cell lung cancer (NSCLC) after surgery. METHODS: Patients with NSCLC who underwent surgery from January 1, 2006, to December 31, 2009 were selected. Cox proportional hazards model and Logistic regression analysis model were used to screen the independent predictors of prognosis of patients. The primary endpoint was postoperative overall survival (OS), and the secondary endpoint was postoperative recurrence-free survival (RFS) and postoperative pulmonary complications (PPCs). RESULTS: A total of 588 patients were included into the final analysis. The overall RFS was 4.4 [interquartile range (IQR), 1.1–10.1] years, and the OS was 6.2 (IQR, 2.4–10.2) years. Age ≥60 years, advanced tumor stage, and maximal tumor size >3 cm were associated with shortened survival, whereas high BMI grade, mediastinal lymph node dissection, perioperative fentanyl equivalents >28.2 µg/kg, and high tumor grade were associated with prolonged survival (P<0.05); perioperative glucocorticoid administration delayed recurrence (P<0.05); advanced tumor stage and perioperative fentanyl equivalents >28.2 µg/kg were associated with an increased PPCs risk (P<0.05). CONCLUSIONS: The findings from this study revealed that perioperative anesthetic factors may impact the prognosis of patients with NSCLC after surgery. Perioperative opioid and glucocorticoid exposure were independent predictors for outcomes. However, perioperative fentanyl equivalents over 28.2 µg/kg seemed to be beneficial to OS, but contribute to the occurrence of PPCs. AME Publishing Company 2023-06-21 2023-09-28 /pmc/articles/PMC10586941/ /pubmed/37868870 http://dx.doi.org/10.21037/jtd-22-1812 Text en 2023 Journal of Thoracic Disease. All rights reserved. https://creativecommons.org/licenses/by-nc-nd/4.0/Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) .
spellingShingle Original Article
Zhu, Wenzhi
Li, Shuang
Ji, Xinqiang
Tan, Hongyu
Impact of anesthetic factors on prognosis of patients with non-small cell lung cancer after surgery
title Impact of anesthetic factors on prognosis of patients with non-small cell lung cancer after surgery
title_full Impact of anesthetic factors on prognosis of patients with non-small cell lung cancer after surgery
title_fullStr Impact of anesthetic factors on prognosis of patients with non-small cell lung cancer after surgery
title_full_unstemmed Impact of anesthetic factors on prognosis of patients with non-small cell lung cancer after surgery
title_short Impact of anesthetic factors on prognosis of patients with non-small cell lung cancer after surgery
title_sort impact of anesthetic factors on prognosis of patients with non-small cell lung cancer after surgery
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10586941/
https://www.ncbi.nlm.nih.gov/pubmed/37868870
http://dx.doi.org/10.21037/jtd-22-1812
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