局部麻醉并未改善肿瘤患者的术后长期生存：一项随机对照试验的系统回顾和荟萃分析

以下文章来源于罂粟花 ，作者anesthGH

本文由“罂粟花”授权转载

局部麻醉并未改善肿瘤患者的术后长期生存：一项随机对照试验的系统回顾和荟萃分析

贵州医科大学  麻醉与心脏电生理课题组

翻译：柏雪

编辑：柏雪

审校：曹莹

目的：

实验研究和临床试验报告了局部麻醉(RA)对癌症预后的影响。我们系统地回顾了RA对肿瘤手术后无复发生存期(RFS)和总生存期(OS)的影响。

方法：

检索PubMed、Cochrane library和Embase数据库，收集从研究开始到2022年6月20日的RCTs（随机对照试验），纳入条件为围术期开始使用任何形式的RA。时间-事件数据（风险比 [HR]）被独立提取并一式两份。主要结果是RA与RFS和OS的关联，而次要结果包括肿瘤进展时间、5年RFS和5年OS。

结果：

纳入15项随机对照试验，共5981名受试者。与GA相比，RA 对RFS（HR，- 0.02；95% CI，- 0.11 - 0.07）、OS（HR，- 0.03；95% CI，- 0.28 - 0.23）、肿瘤进展时间（0.11 ; 95% CI，- 0.33 - 0.55）、5年RFS（风险比 [RR]，1.24；95% CI，0.88 - 1.76））和5年OS（RR，1.11；95% CI，0.85 - 1.44）。基于研究设计、患者特征和肿瘤类型的亚组分析也显示 RA对RFS或OS没有影响。

结论：

我们的结果表明，没有明显的证据支持RA在提高肿瘤手术后的长期生存率方面的作用。

原始文献来源：

Tao Li, Xiangrui Meng, Di Wang, Qiang Wang, et, al. Regional anesthesia did not improve postoperative long-term survival of tumor patients: a systematic review and meta-analysis of randomized controlled trials. World Journal of Surgical Oncology[J]           (2023) 21:68, DOI: 10.1186/s12957-023-02957-3

英文原文：

Regional anesthesia did not improve postoperative long-term survival of tumor patients: a systematic review and meta-analysis of randomized controlled trials

Abstract

Objective Experimental research and clinical trials have reported a positive effect of regional anesthesia (RA) on prognosis of cancers. We systematically reviewed the efficacy of RA on recurrence-free survival (RFS) and overall survival (OS) after oncology surgeries.

Methods PubMed, Cochrane library, and Embase were searched from inception to June 20, 2022 for RCTs in which any form of RA was initiated perioperatively. Time-to-event data (hazard ratio [HR]) were extracted independently and in duplicate. The primary outcome was the association of RA with RFS and OS, while the secondary outcomes included time to tumor progression, 5-year RFS, and 5-year OS.

Results Fifteen RCTs with 5981 participants were included. Compared to GA, RA has no positive effect on RFS (HR, − 0.02; 95% CI, − 0.11 to 0.07), OS (HR, − 0.03; 95% CI, − 0.28 to 0.23), time to tumor progression (0.11; 95% CI, − 0.33 to 0.55), 5-year RFS (risk ratio (RR), 1.24; 95% CI, 0.88 to 1.76)), and 5-year OS (RR, 1.11; 95% CI, 0.85 to 1.44). Subgroup analysis based on study design, patient characteristics and tumor types also showed no effect of RA on RFS or OS.

Conclusions Our results demonstrated that there is no significant evidence supporting the role of RA in improving long-term survival after oncology surgeries.

END

免责声明：

本公众平台所刊载原创或转载内容不代表米勒之声的观点或立场。文中所涉及药物使用、疾病诊疗等内容仅供医学专业人士参考。

END

编辑：Michel.米萱

校对：MiLu.米鹭

打赏