Anaesthetic Type and Survival in Metastatic Colorectal Cancer: A Nationwide Registry Study.
Propensity-matched analysis found no survival difference between propofol and inhalational anaesthesia.
Anaesthetic Type and Survival in Metastatic Colorectal Cancer: A Nationwide Registry Study.
The impact of anaesthetic choice on survival following metastatic cancer surgery is uncertain.
This study aimed to evaluate the association between anaesthetic maintenance with inhalational anaesthesia versus propofol-based total intravenous anaesthesia and overall survival in patients undergoing surgery for metastatic colorectal cancer.
Adult patients (≥ 18 years) with metastatic colorectal cancer who underwent elective or emergency surgery under general anaesthesia from 2014 to 2019 were identified in the Swedish Colorectal Cancer Registry and matched with the Swedish Perioperative Registry.
propofol showed no meaningful survival difference from inhalational anaesthesia after matching
Of the 1233 included patients, 1011 received maintenance anaesthesia with an inhalational agent, and 222 received propofol.
Cox regression analysis identified significant associations between overall survival and advanced age, higher ASA class, emergency surgery, open surgical approach and right-sided tumour location.
Comparison of anaesthetics for the full unmatched cohort observed a statistically significant increased risk of death with propofol (hazard ratio [HR] 1.26, 95% CI 1.02-1.55, p = 0.032).
An apparent association between propofol maintenance and increased mortality observed in the full unmatched cohort was not confirmed in the propensity score-matched cohort.
Poorer survival was independently associated with advanced age, higher ASA class, right-sided tumours and open surgical approach. EDITORIAL COMMENT: It is still not known if clinical anaesthetic exposure can affect cancer outcomes.