Effects of general anesthesia versus local anesthesia in primary hepatocellular carcinoma patients presenting for thermal ablation surgery: a multiple center retrospective cohort study with propensity score matching
机构：[1]Department of Anesthesiology, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200127, China[2]Department of Anesthesiology, The Second Affiliated Hospital, , Hangzhou 310006, China[3]Department of Anesthesiology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310006, China浙江大学医学院附属第一医院[4]Department of Interventional Oncology, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200127, China[5]Department of Anesthesiology, Cancer Hospital, The General Hospital of Ningxia Medical University, Ningxia 750004, China[6]Department of Anesthesiology, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610041, China四川省人民医院四川省肿瘤医院[7]Department of Anesthesiology & Intensive Care, Eastern Hepatobiliary Hospital, The Nary Military Medical University, Shanghai 200438, China[8]Department of Anesthesiology, Fudan University Shanghai Cancer Center, Shanghai, 200032, China
Background: Whether anesthesia methods affect the prognosis of tumor patients is controversial. With the aim of comparing the effects of general anesthesia (GA) and local anesthesia (LA) in primary hepatocellular carcinoma (HCC) patients presenting for elective thermal ablation (TA) surgeries, a multiple center retrospective cohort study was designed and implemented. Methods: Patients who received elective TA surgery under GA or LA from Jan. 2014 to Dec. 2016 and met the eligibility criteria were included. Survival analysis was used to identify the influence of anesthesia methods on recurrence-free survival (RFS) and overall survival (OS). Propensity score matching (PSM) was used to minimize the bias between the GA group and the LA group. Results: A total of 244 patients with GA and 245 with LA were eligible for analysis. After PSM, 178 patients remained in each group. In the matched groups, GA showed a significantly higher recurrence rate compared with LA by both the Kaplan-Meier survival analyses (P=0.011) and multivariable Cox regression analyses (P=0.002). The multivariable Cox regression model also revealed that GA had a hazard ratio (HR) of 1.746 (P=0.036) for death compared with the LA group. Conclusions: GA is associated with decreased RFS and OS after surgery compared with LA in HCC patients undergoing TA surgery. Prospective trials exploring the effects of different anesthetic methods on cancer outcome in these patients are warranted.
基金：
National Natural Science Foundation of ChinaNational Natural Science Foundation of China (NSFC) [81571048, 81571030]; Shanghai Science and Technology Committee FoundationShanghai Science & Technology Committee [19ZR1430600]; Shanghai Municipal Health Commission Foundation [ZY(2018-2020)-ZYJS-48]; Renji Hospital Clinical Innovation Foundation [PYMDT-006]
第一作者机构：[1]Department of Anesthesiology, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200127, China
共同第一作者：
通讯作者：
通讯机构：[1]Department of Anesthesiology, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200127, China[7]Department of Anesthesiology & Intensive Care, Eastern Hepatobiliary Hospital, The Nary Military Medical University, Shanghai 200438, China[*1]Department of Anesthesiology, Renji Hospital, Shanghai Jiaotong University School of Medicine, Pujian Road 160, Pudong District, Shanghai 200127, China[*2]Department of Anesthesiology, Renji Hospital, Shanghai Jiaotong University School of Medicine, Pujian Road 160, Pudong District, Shanghai 200127, China.[*3]Department of Anesthesiology & Intensive Care, Eastern Hepatobiliary Hospital, the Navy Military Medical University, Changhai Road 225, Yangpu District, Shanghai 200438, China.
推荐引用方式(GB/T 7714)：
Wang Xiaoqiang,Xie Weiying,Gan Shuyuan,et al.Effects of general anesthesia versus local anesthesia in primary hepatocellular carcinoma patients presenting for thermal ablation surgery: a multiple center retrospective cohort study with propensity score matching[J].ANNALS OF TRANSLATIONAL MEDICINE.2020,8(6):doi:10.21037/atm.2020.03.88.
APA：
Wang, Xiaoqiang,Xie, Weiying,Gan, Shuyuan,Wang, Tao,Chen, Xuexin...&Tian, Jie.(2020).Effects of general anesthesia versus local anesthesia in primary hepatocellular carcinoma patients presenting for thermal ablation surgery: a multiple center retrospective cohort study with propensity score matching.ANNALS OF TRANSLATIONAL MEDICINE,8,(6)
MLA：
Wang, Xiaoqiang,et al."Effects of general anesthesia versus local anesthesia in primary hepatocellular carcinoma patients presenting for thermal ablation surgery: a multiple center retrospective cohort study with propensity score matching".ANNALS OF TRANSLATIONAL MEDICINE 8..6(2020)
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