PT  - JOURNAL ARTICLE
AU  - Ravi K. Grandhi
AU  - Samuel Lee
AU  - Alaa Abd-Elsayed
TI  - The Relationship Between Regional Anesthesia and Cancer: A Metaanalysis
DP  - 2017 Dec 21
TA  - Ochsner Journal
PG  - 345--361
VI  - 17
IP  - 4
4099  - http://www.ochsnerjournal.org/content/17/4/345.short
4100  - http://www.ochsnerjournal.org/content/17/4/345.full
SO  - Ochsner J2017 Dec 21; 17
AB  - Background: Some studies have suggested using epidural analgesia after cancer surgery to reduce metastasis. This article examines the relationship between regional anesthesia (RA) and cancer metastasis in an array of cancers.Methods: We conducted a review of the literature using PubMed and included 67,577 patients across 28 studies in a metaanalysis, evaluating the hazard ratios (HRs) of overall survival, recurrence-free survival, and biochemical recurrence-free survival.Results: We found no benefit to RA as it relates to cancer. The HR was 0.92 for overall survival, 1.06 for recurrence-free survival, and 1.05 for biochemical recurrence-free survival. Despite the overall analysis showing no benefit, we found some benefit when we evaluated only the randomized trials. However, we found no significant benefit of RA when we evaluated the cancers (gastrointestinal, prostate, breast, and ovarian) individually.Conclusion: This metaanalysis shows that RA has no overall survival, recurrence-free survival, or biochemical recurrence-free survival benefit. However, some individual studies have shown significant benefit in terms of cancer recurrence. Further, RA reduces the use of opioids, which has led to some secondary benefits. Further studies are needed to establish the benefits of RA as it relates to cancer.