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Effect of postoperative analgesia technique on the prognosis of gastric cancer: a retrospective analysis

 Seokyung Shin  ;  Hyoung-Il Kim  ;  Na Young Kim  ;  Ki-Young Lee  ;  Dong Wook Kim  ;  Young Chul Yoo 
 Oncotarget, Vol.8(61) : 104594-104604, 2017 
Journal Title
Issue Date
analgesia ; epidural ; gastric cancer ; patient controlled
Background: Whether regional analgesia techniques have favorable impact on prognosis after cancer surgery is unclear, and existing reports show controversial results. The aim of the present study was to evaluate and compare recurrence and mortality between patients that received either intravenous (IV) or epidural patient controlled analgesia (PCA) for pain control after curative surgery for gastric cancer. Materials and methods: Medical records of patients that underwent curative gastrectomy for gastric cancer between November 2005 and December 2010 were reviewed. Identified patients were categorized according to the use of IV or epidural PCA for postoperative analgesia. Demographic and perioperative variables including type of PCA were analyzed by univariate and multiple regression analysis to investigate any association with recurrence and mortality after surgery. Propensity score matching was done to adjust for selection bias. Results: Of the 3,799 patients included in this analysis, 374 and 3, 425 patients received IV and epidural PCAs, respectively. No difference in recurrence (HR, 1.092; 95% CI 0.859 to 1.388; P = 0.471) or mortality (HR, 0.695; 95% CI 0.429 to 1.125; P = 0.138) was identified between the use of IV and epidural PCA. Propensity score matching also showed no difference in recurrence (HR, 1.098; 95% CI 0.756 to 1.596; P = 0.623) or mortality (HR, 0.855; 95% CI 0.391 to 1.869; P = 0.695) between the two groups. Conclusions: Postoperative use of epidural analgesia was not found to be associated with reduced recurrence or mortality after curative surgery in gastric cancer patients. This finding needs to be confirmed with prospective studies in the future.
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1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
김나영(Kim, Na Young) ORCID logo https://orcid.org/0000-0003-3685-2005
김형일(Kim, Hyoung Il) ORCID logo https://orcid.org/0000-0002-6134-4523
신서경(Shin, Seokyung) ORCID logo https://orcid.org/0000-0002-2641-0070
유영철(Yoo, Young Chul) ORCID logo https://orcid.org/0000-0002-6334-7541
이기영(Lee, Ki Young) ORCID logo https://orcid.org/0000-0003-4893-3195
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