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Peridural Anesthesia and Cancer-Related Survival after Surgery for Pancreatic Cancer—A Retrospective Cohort Study

1
Department of General, Visceral and Pediatric Surgery, University Hospital and Medical Faculty of the Heinrich-Heine-University Düsseldorf, 40225 Düsseldorf, Germany
2
Department of Anesthesiology, University Hospital and Medical Faculty of the Heinrich-Heine-University Düsseldorf, 40225 Düsseldorf, Germany
3
Coordination Center for Clinical Trials and Biostatistics, Heinrich-Heine-University Düsseldorf, 40225 Düsseldorf, Germany
*
Author to whom correspondence should be addressed.
Both authors contributed equally.
§
Current Address: Department of Visceral, Tumor, Transplantation and Vascular Surgery, Cologne-Holweide Hospital, 51067 Cologne, Germany.
Clin. Pract. 2021, 11(3), 532-542; https://doi.org/10.3390/clinpract11030070
Received: 7 May 2021 / Revised: 2 August 2021 / Accepted: 4 August 2021 / Published: 18 August 2021
Background: In patients with prostatic and breast cancer the application of peridural anesthesia (PDA) showed a beneficial effect on prognosis. This was explained by reduced requirements for general anesthetics and perioperative opioids as well as a lower perioperative stress level. The impact of PDA in patients with more aggressive types of cancer has not been completely elucidated. Here, we analyzed the prognostic influence of PDA on overall survival after surgery as primary in patients that underwent radical resection of pancreatic adenocarcinoma. Methods: Records of 98 consecutive patients were reviewed. In 70 of these cases PDA was applied. Patient characteristics such as demographics, TNM stage, and operative data were retrospectively collected from medical records and analyzed. Survival data were analyzed by Cox’s proportional hazard regression model. Results: Overall, no significant prognostic influence of PDA on recurrence or overall survival (p = 0.762, Hazard Ratio [HR] 0.884, 95% confidence interval [CI] 0.398–1.961) was found. However, there was a trend towards a longer overall survival (p = 0.069, HR 0.394, 95% CI 0.144–1.078) associated with PDA in a subgroup of patients with better differentiation of pancreatic adenocarcinoma. Conclusion: The observation of longer survival associated with PDA in our subgroup of patients with better-differentiated pancreatic carcinomas is in line with previous reports on various other less aggressive tumor entities. Our results indicate that PDA might improve the oncological outcome of patients with pancreatic adenocarcinoma. View Full-Text
Keywords: oncological outcome; staging; recurrence; pancreatic adenocarcinoma oncological outcome; staging; recurrence; pancreatic adenocarcinoma
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MDPI and ACS Style

Alexander, A.; Lehwald-Tywuschik, N.; Rehders, A.; Rabenalt, S.; Verde, P.E.; Eisenberger, C.F.; Picker, N.; Knoefel, W.T.; Kienbaum, P. Peridural Anesthesia and Cancer-Related Survival after Surgery for Pancreatic Cancer—A Retrospective Cohort Study. Clin. Pract. 2021, 11, 532-542. https://doi.org/10.3390/clinpract11030070

AMA Style

Alexander A, Lehwald-Tywuschik N, Rehders A, Rabenalt S, Verde PE, Eisenberger CF, Picker N, Knoefel WT, Kienbaum P. Peridural Anesthesia and Cancer-Related Survival after Surgery for Pancreatic Cancer—A Retrospective Cohort Study. Clinics and Practice. 2021; 11(3):532-542. https://doi.org/10.3390/clinpract11030070

Chicago/Turabian Style

Alexander, Andrea, Nadja Lehwald-Tywuschik, Alexander Rehders, Stefanie Rabenalt, Pablo E. Verde, Claus F. Eisenberger, Nina Picker, Wolfram T. Knoefel, and Peter Kienbaum. 2021. "Peridural Anesthesia and Cancer-Related Survival after Surgery for Pancreatic Cancer—A Retrospective Cohort Study" Clinics and Practice 11, no. 3: 532-542. https://doi.org/10.3390/clinpract11030070

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