Paravertebral block in regional anesthesia with propofol sedation reduces locoregional recurrence in patients with breast cancer receiving breast conservative surgery compared with volatile inhalational without propofol in general anesthesia

Jiaqiang Zhang, Chia Lun Chang, Chang Yun Lu, Ho Min Chen, Szu Yuan Wu

Research output: Contribution to journalArticlepeer-review

4 Citations (Scopus)

Abstract

Purpose: We examined locoregional recurrence (LRR) in patients with breast invasive ductal carcinoma (IDC) receiving breast conservative surgery (BCS) under propofol-based paravertebral block-regional anesthesia (PB-RA) versus sevoflurane-based inhalational general anesthesia (INHA-GA) without propofol. All-cause death and distant metastasis were secondary endpoints. Patients and methods: Patients with breast IDC receiving BCS were recruited through propensity score matching and categorized into INHA-GA with sevoflurane and PB-RA with propofol groups. Cox regression analysis was performed to calculate hazard ratios (HRs) and 95% confidence intervals (CIs). Results: In the multivariate Cox regression analysis, the adjusted HR (aHR; 95% CI) of LRR for the PB-RA with propofol group was 0.67 (0.46–0.99) compared with the INHA-GA with sevoflurane group. The aHRs of LRR for differentiation grade II, grade III, the American Joint Committee on Cancer clinical stage II, stage III, pathological tumor (pT) stage 2, pT stage 3–4, pathological nodal (pN) stage 2–3, and Her-2 positivity were 1.87 (1.03–3.42), 2.31 (1.20–4.44), 1.67 (1.09–2.56), 2.43 (1.18–4.97), 1.17 (1.03–1.19), 1.28 (1.13–2.24), 1.20 (1.05–2.22), and 1.59 (1.01–2.51), respectively, compared with those for differentiation grade I, clinical stage I, pT1, pN0, and HER-2 negativity. The aHR of LRR for adjuvant radiotherapy was 0.60 (0.38–0.97) compared with that for no adjuvant radiotherapy. Conclusion: PB-RA with propofol might be beneficial for reducing LRR in women with breast IDC receiving BCS compared with INHA-GA without propofol.

Original languageEnglish
Article number111991
JournalBiomedicine and Pharmacotherapy
Volume142
DOIs
Publication statusPublished - Oct 2021

Keywords

  • Breast conservative surgery
  • Breast invasive ductal carcinoma
  • Locoregional recurrence
  • Propofol
  • Sevoflurane

ASJC Scopus subject areas

  • Pharmacology

Fingerprint

Dive into the research topics of 'Paravertebral block in regional anesthesia with propofol sedation reduces locoregional recurrence in patients with breast cancer receiving breast conservative surgery compared with volatile inhalational without propofol in general anesthesia'. Together they form a unique fingerprint.

Cite this