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. 2023 Dec;41(12):2721-2729.
doi: 10.1002/jor.25597. Epub 2023 May 18.

Regional anesthesia is associated with improved metastasis free survival after surgical resection of bone sarcomas

Bijan Abar  1 , Junheng Gao  2 , Amanda N Fletcher  1 , Elizbeth Sachs  1 , Andrew H Wong  3 , Alexander L Lazarides  1 , Chinedu Okafor  1 , Brian E Brigman  1 , William C Eward  1 , Sin-Ho Jung  2 , Amanda H Kumar  3 , Julia D Visgauss  1
Affiliations

Regional anesthesia is associated with improved metastasis free survival after surgical resection of bone sarcomas

Bijan Abar et al. J Orthop Res. 2023 Dec.

Abstract

There is increasing evidence that perioperative factors, including type of anesthesia, may be an important consideration regarding oncological disease progression. Previous studies have suggested that regional anesthesia can improve oncological outcomes by reducing the surgical stress response that occurs during tumor resection surgery and that may promote metastatic progression. The purpose of this study is to provide the first robust investigation of the impact of adding regional anesthesia to general anesthesia on oncological outcomes following sarcoma resection. One hundred patients with bone sarcoma were retrospectively analyzed in this study. After adjusting for confounding variables such as age and grade of the tumor, patients with bone sarcoma receiving regional anesthesia in addition to general anesthesia during resection had improved metastasis free survival (multivariate hazard ratio of 0.47 and p = 0.034). Future studies are needed to confer the beneficial effect of regional anesthesia, and to further investigate the potential mechanism. Clinical significance: The results from this study provide evidence that regional anesthesia may be advantageous in the setting of bone sarcoma resection surgery, reducing pain while also improving oncological outcomes and should be considered when clinically appropriate.

Keywords: cancer/tumors; statistics; surgical repair; treatment.

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Conflict of interest statement

All authors declare that they have no professional or financial conflict of interest related to the content of this manuscript.

Figures

Figure 1:
Figure 1:
Flow chart outlining the exclusion criteria used to identify the final study cohort.
Figure 2:
Figure 2:
Kaplan Meier Curves comparing MFS between patients with bone sarcoma who received regional + general versus general only anesthesia during their tumor resection surgery shows that patients who received regional anesthesia have improved survival.
Figure 3:
Figure 3:
Forest plot showing univariate hazard ratios of diagnosed metastases or death for patients with bone sarcoma following a wide margin tumor resection surgery.
See this image and copyright information in PMC

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