Author(s): Lu, Yanan ; Liu, Ting ; Wang, Peizong ; Chen, Yi ; Ji, Fengtao ; Hernanz, Fernando ; Zucca-Matthes, Gustavo [UNESP] ; Youssif, Sherif ; Peng, Shuling ; Xu, Dongni
Date: 2022
Persistent ID: http://hdl.handle.net/11449/218676
Origin: Oasisbr
Subject(s): General anesthesia; epidural anesthesia; pain; breast cancer; metastasis; recurrence
Made available in DSpace on 2022-04-28T17:22:28Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-09-01
Natural Science Foundation of Guangdong Province
Background: Breast cancer is currently the leading cause of women's death. It is crucial to further improve the approach to treatment and the long-term survival rate of breast cancer patients, and to reduce the rates of recurrence and metastasis. It has been reported that the possibility of tumor metastasis depends on the metastatic potential of the tumor and the host defense against tumor metastasis, in which cellular immunity and the function of natural killer (NK) cells are critical to maintaining this balance. Surgical stress response and postoperative pain inhibit perioperative immune function in patients and increase the likelihood of dissemination and metastasis of cancer cells after cancer surgery. The study aims to investigate the effect of anesthetic factors and pain treatment on the long-term prognosis of patients with early stage lymph node negative breast preservation surgery. Methods: A total of 337 patients with early-stage lymph node negative breast cancer (ASA I-II) who had undergone successful breast-conserving surgery in our hospital were included in this retrospective analysis. Cases were divided into general anesthesia with postoperative analgesia group (GA + PCA), general anesthesia without postoperative analgesia group (GA), epidural anesthesia with postoperative analgesia group (EA + PCA), and epidural anesthesia without postoperative analgesia group (EA). The 5-year survival rate and 5-year disease-free survival were recorded in the 4 groups. Results: The general condition and length of hospital stay of the patients were not statistically different between the 4 groups. However, the 5-year survival rate and 5-year disease-free survival rate of the 4 groups were statistically different. The 5-year survival rate and 5-year disease-free survival rate were the lowest in the GA group, while the EA + PCA group had the highest 5-year disease-free survival rate. The 5-year survival rate and 5-year disease-free survival rate in the GA + PCA group were significantly higher than those in the GA group. The 5-year disease-free survival rate in EA group was significantly higher than GA group. Conclusions: Epidural anesthesia and postoperative pain treatment maybe beneficial to the long-term prognosis of patients with early-stage lymph node-negative breast cancer.
Sun Yat Sen Univ, Sun Yat Sen Mem Hosp, Dept Anesthesiol, Guangzhou, Peoples R China
Sun Yat Sen Univ, Dept Anesthesiol, Canc Ctr, Guangzhou, Peoples R China
Su Fengxi Clin, Guangzhou, Peoples R China
Univ Cantabria, Hosp Univ Valdecilla, Oncoplast Breast Unit, Santander, Spain
UNESP, Sch Med Botucatu, Dept Gynaecol Obstet & Mastol, Botucatu, SP, Brazil
Univ Hosp Birmingham NHS Trust, Good Hope Hosp, Plast & Reconstruct Surg Div, Birmingham, W Midlands, England
Assiut Univ, Dept Plast Surg, Assiut, Egypt
UNESP, Sch Med Botucatu, Dept Gynaecol Obstet & Mastol, Botucatu, SP, Brazil
Natural Science Foundation of Guangdong Province: 2021A1515012357
