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The anesthetist’s choice of inhalational vs. intravenous anesthetics has no impact on survival of glioblastoma patients
Recent data suggest that the type of anesthesia used during the resection of solid tumors impacts the long-term survival of patients favoring total-intravenous-anesthesia (TIVA) over inhalative-anesthesia (INHA). Here we sought to query this impact on survival in patients undergoing resection of gli...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Berlin Heidelberg
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8490243/ https://www.ncbi.nlm.nih.gov/pubmed/33354749 http://dx.doi.org/10.1007/s10143-020-01452-7 |
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author | Schmoch, Thomas Jungk, Christine Bruckner, Thomas Haag, Sabine Zweckberger, Klaus von Deimling, Andreas Brenner, Thorsten Unterberg, Andreas Weigand, Markus A. Uhle, Florian Herold-Mende, Christel |
author_facet | Schmoch, Thomas Jungk, Christine Bruckner, Thomas Haag, Sabine Zweckberger, Klaus von Deimling, Andreas Brenner, Thorsten Unterberg, Andreas Weigand, Markus A. Uhle, Florian Herold-Mende, Christel |
author_sort | Schmoch, Thomas |
collection | PubMed |
description | Recent data suggest that the type of anesthesia used during the resection of solid tumors impacts the long-term survival of patients favoring total-intravenous-anesthesia (TIVA) over inhalative-anesthesia (INHA). Here we sought to query this impact on survival in patients undergoing resection of glioblastoma (GBM). All patients receiving elective resection of a newly diagnosed, isocitrate-dehydrogenase-1-(IDH1)-wildtype GBM under general anesthesia between January 2010 and June 2017 in the Department of Neurosurgery, Heidelberg University Hospital, were included. Patients were grouped according to the applied anesthetic technique. To adjust for potential prognostic confounders, patients were matched in a 1:2 ratio (TIVA vs. INHA), taking into account the known prognostic factors: age, extent of resection, O-6-methylguanine-DNA-methyltransferase-(MGMT)-promoter-methylation-status, pre-operative Karnofsky-performance-index and adjuvant radio- and chemotherapy. The primary endpoint was progression-free-survival (PFS) and the secondary endpoint was overall-survival (OS). In the study period, 576 patients underwent resection of a newly diagnosed, IDH-wildtype GBM. Patients with incomplete follow-up-data, on palliative treatment, having emergency or awake surgery; 54 patients remained in the TIVA-group and 417 in the INHA-group. After matching, 52 patients remained in the TIVA-group and 92 in the INHA-group. Median PFS was 6 months in both groups. The median OS was 13.5 months in the TIVA-group and 13.0 months in the INHA-group. No significant survival differences associated with the type of anesthesia were found either before or after adjustment for known prognostic factors. This retrospective study supports the notion that the current anesthetic approaches employed during the resection of IDH-wildtype GBM do not impact patient survival. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s10143-020-01452-7. |
format | Online Article Text |
id | pubmed-8490243 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Springer Berlin Heidelberg |
record_format | MEDLINE/PubMed |
spelling | pubmed-84902432021-10-15 The anesthetist’s choice of inhalational vs. intravenous anesthetics has no impact on survival of glioblastoma patients Schmoch, Thomas Jungk, Christine Bruckner, Thomas Haag, Sabine Zweckberger, Klaus von Deimling, Andreas Brenner, Thorsten Unterberg, Andreas Weigand, Markus A. Uhle, Florian Herold-Mende, Christel Neurosurg Rev Original Article Recent data suggest that the type of anesthesia used during the resection of solid tumors impacts the long-term survival of patients favoring total-intravenous-anesthesia (TIVA) over inhalative-anesthesia (INHA). Here we sought to query this impact on survival in patients undergoing resection of glioblastoma (GBM). All patients receiving elective resection of a newly diagnosed, isocitrate-dehydrogenase-1-(IDH1)-wildtype GBM under general anesthesia between January 2010 and June 2017 in the Department of Neurosurgery, Heidelberg University Hospital, were included. Patients were grouped according to the applied anesthetic technique. To adjust for potential prognostic confounders, patients were matched in a 1:2 ratio (TIVA vs. INHA), taking into account the known prognostic factors: age, extent of resection, O-6-methylguanine-DNA-methyltransferase-(MGMT)-promoter-methylation-status, pre-operative Karnofsky-performance-index and adjuvant radio- and chemotherapy. The primary endpoint was progression-free-survival (PFS) and the secondary endpoint was overall-survival (OS). In the study period, 576 patients underwent resection of a newly diagnosed, IDH-wildtype GBM. Patients with incomplete follow-up-data, on palliative treatment, having emergency or awake surgery; 54 patients remained in the TIVA-group and 417 in the INHA-group. After matching, 52 patients remained in the TIVA-group and 92 in the INHA-group. Median PFS was 6 months in both groups. The median OS was 13.5 months in the TIVA-group and 13.0 months in the INHA-group. No significant survival differences associated with the type of anesthesia were found either before or after adjustment for known prognostic factors. This retrospective study supports the notion that the current anesthetic approaches employed during the resection of IDH-wildtype GBM do not impact patient survival. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s10143-020-01452-7. Springer Berlin Heidelberg 2020-12-22 2021 /pmc/articles/PMC8490243/ /pubmed/33354749 http://dx.doi.org/10.1007/s10143-020-01452-7 Text en © The Author(s) 2020 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Original Article Schmoch, Thomas Jungk, Christine Bruckner, Thomas Haag, Sabine Zweckberger, Klaus von Deimling, Andreas Brenner, Thorsten Unterberg, Andreas Weigand, Markus A. Uhle, Florian Herold-Mende, Christel The anesthetist’s choice of inhalational vs. intravenous anesthetics has no impact on survival of glioblastoma patients |
title | The anesthetist’s choice of inhalational vs. intravenous anesthetics has no impact on survival of glioblastoma patients |
title_full | The anesthetist’s choice of inhalational vs. intravenous anesthetics has no impact on survival of glioblastoma patients |
title_fullStr | The anesthetist’s choice of inhalational vs. intravenous anesthetics has no impact on survival of glioblastoma patients |
title_full_unstemmed | The anesthetist’s choice of inhalational vs. intravenous anesthetics has no impact on survival of glioblastoma patients |
title_short | The anesthetist’s choice of inhalational vs. intravenous anesthetics has no impact on survival of glioblastoma patients |
title_sort | anesthetist’s choice of inhalational vs. intravenous anesthetics has no impact on survival of glioblastoma patients |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8490243/ https://www.ncbi.nlm.nih.gov/pubmed/33354749 http://dx.doi.org/10.1007/s10143-020-01452-7 |
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