Cancer-Free or Overall Survival Rate Following Radical Prostatectomy is not Influenced by Perioperative Pain ManagementKamuf J, Pospich M and Heid F*
Department of Anesthesiology, University Medical Centre of Johannes Gutenberg University, Langenbeckstraße 1, 55131 Mainz, Germany
- *Corresponding Author:
- Heid F
Department of Anesthesiology
University Medical Centre of Johannes Gutenberg University
Langenbeckstr, 1, 55131 Mainz,Germany
Fax: 496131 176649
E-mail: [email protected]
Received date:June 22, 2014; Accepted date: July 22, 2014; Published date: July 29, 2014
Citation: Kamuf J, Pospich M, Heid F (2014) Cancer-Free or Overall Survival Rate Following Radical Prostatectomy is not Influenced by Perioperative Pain Management. J Anesth Clin Res 5:422. doi: 10.4172/2155-6148.1000422
Copyright: © 2014 Kamuf J, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Objective: There is controversial data regarding influence of anesthetic techniques on the outcome of patients undergoing cancer surgery. In particular, whether patients benefit from the application of regional techniques is elaborately discussed. Therefore we enrolled a retrospective analysis to determine the influence of different anesthetic techniques in patients who underwent radical prostatectomy due to prostate cancer.
Methods: After ethics approval, we viewed our medical record archive for patients that received radical prostatectomy between 1995 and 2005 and included 300 patients. They were divided according to their postoperative pain regime (systemic opioids vs. epidural analgesia). Recurrence-free survival was defined as the primary endpoint and overall survival as the secondary endpoint. The study period covered at least the first five post-operative years.
Results: We documented no difference in recurrence-free or overall survival comparing the two analgesic regimes. However, we observed that higher body-mass-indexes (BMI) significantly correlated with a worse outcome (recurrence-free survival p=0.037, overall survival p=0.02). Other factors influencing the outcome were the Gleason score (5-6 vs. 10 p=0.016; 7 vs. 10 p=0.08) and surgical margins free of cancer (p=0.04).
Conclusion: In this study, different anesthetic techniques did not influence recurrence-free or overall survival rate. Interestingly, we could identify BMI as a risk factor with potential impact on the outcome of patients undergoing radical prostatectomy. Adequately powered prospective randomized trials are required to decide on the effect of regional anesthesia in patients who underwent radical prostatectomy.