Type of anesthesia not linked to breast cancer recurrence rate, finds study

There is no link between the type of anesthesia used and long-term prognosis of breast cancer. Therefore, choosing an IV or inhalation anesthesia for breast cancer surgery may not hold any significance, revealed a study published in the journal Anesthesiology.

Cancer recurrence is one of the major fears faced by breast cancer patients who go for surgery. Studies have found that both surgery and anesthesia suppress cell-mediated immunity and increase angiogenesis and can, therefore, promote proliferation and metastasis of cancer cells during the perioperative period. But how much it holds true for all the modalities of anesthesia is a million dollar question for medical researchers.

Some clinical studies showed that the survival of patients getting total IV anesthesia is better than those who receive inhalation anesthesia.

To ascertain this link between cancer recurrence and type of anesthetic used in surgery the authors conducted a retrospective cohort study to compare the influence of total IV anesthesia and inhalation anesthesia on the primary outcome of recurrence-free survival after breast cancer surgery.

The authors reviewed the electronic medical records of patients who had breast cancer surgery at a tertiary care teaching hospital between January 2005 and December 2013. The patients were grouped according to whether IV or inhalation anesthesia was used for surgery. Propensity score matching was used to account for differences in baseline characteristics. Kaplan-Meier survival curves were constructed to evaluate the influence of the type of anesthesia on recurrence-free survival and overall survival. The risks of cancer recurrence and all-cause mortality were compared between each type of anesthesia.

The authors found that of 7,678 patients who had breast cancer surgery during the study period, data for 5,331 patients were available for analysis, with a total of 3,085 patients in the IV group and 2,246 patients in the inhalation group. After propensity score matching, 1,766 patients remained in each group.

Kaplan-Meier survival curves showed that there was no significant difference in recurrence-free survival or overall survival between the two groups, with 5-yr recurrence-free survival rates of 93.2% in the IV group and 93.8% in the inhalation group. Inhalation anesthesia had no significant impact on recurrence-free survival or overall survival when compared with total IV anesthesia.

The authors concluded that there no association between the type of anesthesia used and the long-term prognosis of breast cancer. The results of this retrospective cohort study do not suggest a specific selection of IV or inhalation anesthesia for breast cancer surgery.

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DOI: 10.1097/ALN.0000000000002491