Abstract
Previous research has shown that anesthetic techniques can influence patient outcomes following cancer surgery. However, the effects of anesthesia in patients undergoing glioblastoma surgery are still not known. We studied the relationship between the type of anesthesia and patient outcomes following elective glioblastoma surgery. This was a retrospective cohort study of patients who underwent elective glioblastoma surgery between January 2008 and December 2018. Patients were grouped according to the anesthesia they received, desflurane or propofol. A Kaplan-Meier analysis was conducted, and survival curves were presented from the date of surgery to death. Univariable and multivariable Cox regression models were used to compare hazard ratios for death after propensity matching. A total of 50 patients (45 deaths, 90.0%) under desflurane anesthesia and 53 patients (38 deaths, 72.0%) under propofol anesthesia were included. Thirty-eight patients remained in each group after propensity matching. Propofol anesthesia was associated with improved survival (hazard ratio, 0.51; 95% confidence interval, 0.30-0.85; P = 0.011) in a matched analysis. Furthermore, patients under propofol anesthesia exhibited less postoperative recurrence than those under desflurane anesthesia (hazard ratio, 0.60; 95% confidence interval, 0.37-0.98; P = 0.040) in a matched analysis. In this limited sample size, we observed that propofol anesthesia was associated with improved survival and less postoperative recurrence in glioblastoma surgery than desflurane anesthesia. Further investigations are needed to examine the influence of propofol anesthesia on patient outcomes following glioblastoma surgery.
Highlights
Glioblastoma (GBM, World Health Organization grade IV) is the most common malignant primary brain tumor, with an incidence of 3.19 cases per 100,000 person-years [1]
We studied the relationship between the type of anesthesia and patient outcomes following elective glioblastoma surgery
Propofol anesthesia was associated with improved survival in a matched analysis
Summary
Glioblastoma (GBM, World Health Organization grade IV) is the most common malignant primary brain tumor, with an incidence of 3.19 cases per 100,000 person-years [1]. Surgical resection plays an important role in the treatment of GBM [2], surgical intervention may result in neuroendocrine and metabolic changes, which may impair cell-mediated immunity and activate the implantation of circulating tumor cells [3]. This potential combination of impaired immune responses and cancer cell seeding enhances the susceptibility of patients undergoing cancer surgery to the development of postoperative metastasis associated with poor survival. The potential role of anesthetic techniques in cancer survival, postoperative recurrence, or metastasis formation has attracted attention. We studied the relationship between the type of anesthesia and patient outcomes following elective glioblastoma surgery
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