Publication

Peridural analgesia does not impact survival in patients after colon cancer resection: a retrospective propensity score-adjusted analysis

Journal Paper/Review - Jun 6, 2019

Units
PubMed
Doi

Citation
Wurster E, Tarantino I, Büchler M, Schmied B, Weigand M, Brenner T, Antony P, Warschkow R, Pianka F, Ulrich A. Peridural analgesia does not impact survival in patients after colon cancer resection: a retrospective propensity score-adjusted analysis. Int J Colorectal Dis 2019; 34:1283-1293.
Type
Journal Paper/Review (English)
Journal
Int J Colorectal Dis 2019; 34
Publication Date
Jun 6, 2019
Issn Electronic
1432-1262
Pages
1283-1293
Brief description/objective

PURPOSE
To assess the putative impact of peridural analgesia on oncological outcome in patients undergoing resection of stages I-IV colon cancer.

METHODS
In a single-center study, 876 patients undergoing resection for primary colon cancer (AJCC stages I-IV) between 2001 and 2014 were analyzed. Mean follow-up of the entire cohort was 4.2 ± 3.5 years. Patients who did and did not receive peridural analgesia were compared using Cox regression and propensity score analyses.

RESULTS
Overall, 208 patients (23.7%) received peridural analgesia. Patients' characteristics were biased with regard to the use of peridural analgesia (propensity score 0.296 ± 0.129 vs. 0.219 ± 0.108, p < 0.001). After propensity score matching, the use of peridural analgesia had no impact on overall (HR 0.81, 95% CI 0.59-1.11, p = 0.175), cancer-specific (HR 0.72, 95% CI 0.48-1.09, p = 0.111), and disease-free survival (HR 0.89, 95% CI 0.66-1.19, p = 0.430). The 5-year overall survival after propensity score matching was 60.9% (95% CI 54.8-67.7%) for patients treated with peridural analgesia compared with 54.1% (95% CI 49.5-59.1%) for patients not treated with peridural analgesia. Cancer-specific and disease-free survival showed similar non-significant results.

CONCLUSIONS
Peridural analgesia in patients after colon cancer resection was not associated with a better oncological outcome after risk adjusting in multivariable Cox regression and propensity score analyses. Hence, oncological outcome should not serve as a reason for the use of peridural analgesia in patients with colon cancer.