Impact of Propofol-based Total Intravenous Anesthesia Versus Inhalation Anesthesia on Long-term Survival After Cancer Surgery in a Nationwide Cohort
Main finding · All-cause mortality after cancer surgeryResult — go to the resultAdjusted HR for all-cause mortality 0.98 95% CI 0.93–1.04Authors' conclusion
There is no association between the type of general anesthesia used during cancer surgery and postoperative overall, 1-, and 5-year survival.
Study context
- Population
- Adults undergoing cancer resection surgery (breast, gastric, lung, liver, kidney, colorectal, pancreatic, esophageal, bladder) under GA, Korean National Health Insurance Service data, 2007–2016eligible for analysis
- Participants
- 312,985 adults
- Exposure
- Propofol-based total intravenous anesthesia (TIVA) vs inhalational anesthesia
- TIVAn = 37,063
- Inhalational anesthesia (IA)n = 275,922reference
- Outcome
- Overall survival after surgery, by cancer type
Methodological detailsnationwide, propensity score-based inverse probability of treatment weighting, time-dependent Cox regression, with meta-analysis
- Nationwide
- Propensity score-based inverse probability of treatment weighting
- Time-dependent Cox regression
- With meta-analysis
Main finding
All-cause mortality after cancer surgery
Adjusted HR for all-cause mortality
0.98
95% CI 0.93–1.04
Events by group
TIVA vs IA
adjusted HR for all-cause mortality 0.98 (95% CI 0.93–1.04)
As reported in the abstract
Observational data: associations, not effects.
Further findings
| Outcome | Pooled adjusted HR (95% CI) | P value | |
|---|---|---|---|
| Overall survival, meta-analysis of single-center studies | 0.65 (0.47–0.91) | P = 0.01 | |
| Overall survival, meta-analysis of multicenter studies | 1.05 (0.82–1.33) | P = 0.71 | |
| 0.512Pooled adjusted hazard ratio (log scale) |
Original publication
Impact of Propofol-based Total Intravenous Anesthesia Versus Inhalation Anesthesia on Long-term Survival After Cancer Surgery in a Nationwide Cohort. Ann Surg. Published 15 July 2022. doi:10.
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