Effect of epidural analgesia on cancer prognosis after colon cancer resection: A single-centre cohort study in Taiwan

Hsiang Ling Wu, Ying Hsuan Tai, Mercedes Susan Mandell, Mei Yung Tsou, Shung Haur Yang, Tony Hsiu Hsi Chen, Kuang Yi Chang

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives Whether epidural analgesia affects cancer outcomes remains controversial. Most previous investigations ignored the confounding potential of important pathological factors on cancer outcomes. This study aimed to assess the association between epidural analgesia and cancer recurrence or death after resections for colon cancer. Design Retrospective cohort study. Setting A single-medical centre in Taiwan. Participants Patients with stage I through III colon cancer undergoing bowel resection and receiving either epidural analgesia or intravenous opioid analgesia from 2005 to 2014. Primary and secondary outcome measures Primary outcome was postoperative recurrence-free survival and secondary outcome was overall survival. Results A total of 2748 and 1218 patients were analysed before and after propensity score matching. Cox regression analyses did not demonstrate any association between epidural analgesia and recurrence or death after matching (HR 0.89, 95% CI 0.65 to 1.21 for recurrence; 0.72, 95% CI 0.48 to 1.09 for death). Independent prognostic factors for cancer recurrence and death were higher level of preoperative carcinoembryonic antigen, perioperative blood transfusion, advanced cancer stage and pathological lymphovascular invasion. Conclusions No definite association was found between epidural analgesia and risk of recurrence or death in patients undergoing colon cancer resection.

Original languageEnglish
Article numbere036577
JournalBMJ Open
Volume10
Issue number10
DOIs
Publication statusPublished - Oct 22 2020

Keywords

  • anaesthesia in oncology
  • colorectal surgery
  • gastrointestinal tumours
  • pain management

ASJC Scopus subject areas

  • Medicine(all)

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