Retrospective Comparison between the Effects of Propofol and Inhalation Anesthetics on Postoperative Recurrence of Early- and Intermediate-Stage Hepatocellular Carcinoma
Objective: Previous studies have reported that propofol has antitumor, anti-inflammatory, and antioxidant effects in addition to its anesthetic properties. To confirm this, a retrospective investigation was conducted to determine whether different anesthetic agents, particularly propofol and inhalat...
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| Published in | Medical principles and practice Vol. 29; no. 5; pp. 422 - 428 |
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| Main Authors | , , , |
| Format | Journal Article |
| Language | English |
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Basel, Switzerland
S. Karger AG
01.09.2020
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| Abstract | Objective: Previous studies have reported that propofol has antitumor, anti-inflammatory, and antioxidant effects in addition to its anesthetic properties. To confirm this, a retrospective investigation was conducted to determine whether different anesthetic agents, particularly propofol and inhalation anesthetics, have an effect on the recurrence of hepatocellular carcinoma (HCC) in patients who were diagnosed with primary HCC and underwent laparoscopic hepatectomy. Subjects and Methods: Patients with Barcelona Clinic Liver Cancer stages 0, A, and B HCC, who underwent laparoscopic hepatic resection, were enrolled in this study. Postoperative HCC recurrence, which was determined from postoperative liver CT, was evaluated 24 months postoperatively with respect to the main anesthetic agents. The characteristics of HCC and other patient-related or surgery-related variables were evaluated together. Results and Conclusion: During the 24-month period after hepatic resection, less HCC patients in the propofol group than in the inhalation group recurred (p = 0.046). The mean time to recurrence was 20.8 months (95% CI, 19.7–22.0) and 19.1 months (95% CI, 17.8–20.4) in the propofol group and the inhalation group, respectively. In addition, multivariable Cox proportional regression analysis revealed that the propofol group showed significantly decreased recurrence versus the inhalation group (hazard ratio, 0.57; 95% CI, 0.47–0.69; p = 0.029). When propofol was used as the main general anesthetic agent for laparoscopic hepatic resection, the postoperative 2-year recurrence rate decreased in early- and intermediate-stage HCC. |
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| AbstractList | Objective: Previous studies have reported that propofol has antitumor, anti-inflammatory, and antioxidant effects in addition to its anesthetic properties. To confirm this, a retrospective investigation was conducted to determine whether different anesthetic agents, particularly propofol and inhalation anesthetics, have an effect on the recurrence of hepatocellular carcinoma (HCC) in patients who were diagnosed with primary HCC and underwent laparoscopic hepatectomy. Subjects and Methods: Patients with Barcelona Clinic Liver Cancer stages 0, A, and B HCC, who underwent laparoscopic hepatic resection, were enrolled in this study. Postoperative HCC recurrence, which was determined from postoperative liver CT, was evaluated 24 months postoperatively with respect to the main anesthetic agents. The characteristics of HCC and other patient-related or surgery-related variables were evaluated together. Results and Conclusion: During the 24-month period after hepatic resection, less HCC patients in the propofol group than in the inhalation group recurred (p = 0.046). The mean time to recurrence was 20.8 months (95% CI, 19.7–22.0) and 19.1 months (95% CI, 17.8–20.4) in the propofol group and the inhalation group, respectively. In addition, multivariable Cox proportional regression analysis revealed that the propofol group showed significantly decreased recurrence versus the inhalation group (hazard ratio, 0.57; 95% CI, 0.47–0.69; p = 0.029). When propofol was used as the main general anesthetic agent for laparoscopic hepatic resection, the postoperative 2-year recurrence rate decreased in early- and intermediate-stage HCC. Previous studies have reported that propofol has antitumor, anti-inflammatory, and antioxidant effects in addition to its anesthetic properties. To confirm this, a retrospective investigation was conducted to determine whether different anesthetic agents, particularly propofol and inhalation anesthetics, have an effect on the recurrence of hepatocellular carcinoma (HCC) in patients who were diagnosed with primary HCC and underwent laparoscopic hepatectomy.OBJECTIVEPrevious studies have reported that propofol has antitumor, anti-inflammatory, and antioxidant effects in addition to its anesthetic properties. To confirm this, a retrospective investigation was conducted to determine whether different anesthetic agents, particularly propofol and inhalation anesthetics, have an effect on the recurrence of hepatocellular carcinoma (HCC) in patients who were diagnosed with primary HCC and underwent laparoscopic hepatectomy.Patients with Barcelona Clinic Liver Cancer stages 0, A, and B HCC, who underwent laparoscopic hepatic resection, were enrolled in this study. Post-operative HCC recurrence, which was determined from postoperative liver CT, was evaluated 24 months postoperatively with respect to the main anesthetic agents. The characteristics of HCC and other patient-related or surgery-related variables were evaluated together.SUBJECTS AND METHODSPatients with Barcelona Clinic Liver Cancer stages 0, A, and B HCC, who underwent laparoscopic hepatic resection, were enrolled in this study. Post-operative HCC recurrence, which was determined from postoperative liver CT, was evaluated 24 months postoperatively with respect to the main anesthetic agents. The characteristics of HCC and other patient-related or surgery-related variables were evaluated together.During the 24-month period after hepatic resection, less HCC patients in the propofol group than in the inhalation group recurred (p = 0.046). The mean time to recurrence was 20.8 months (95% CI, 19.7-22.0) and 19.1 months (95% CI, 17.8-20.4) in the propofol group and the inhalation group, respectively. In addition, multivariable Cox proportional regression analysis revealed that the propofol group showed significantly decreased recurrence versus the inhalation group (hazard ratio, 0.57; 95% CI, 0.47-0.69; p = 0.029). When propofol was used as the main general anesthetic agent for laparoscopic hepatic resection, the postoperative 2-year recurrence rate decreased in early- and intermediate-stage HCC.RESULTS AND CONCLUSIONDuring the 24-month period after hepatic resection, less HCC patients in the propofol group than in the inhalation group recurred (p = 0.046). The mean time to recurrence was 20.8 months (95% CI, 19.7-22.0) and 19.1 months (95% CI, 17.8-20.4) in the propofol group and the inhalation group, respectively. In addition, multivariable Cox proportional regression analysis revealed that the propofol group showed significantly decreased recurrence versus the inhalation group (hazard ratio, 0.57; 95% CI, 0.47-0.69; p = 0.029). When propofol was used as the main general anesthetic agent for laparoscopic hepatic resection, the postoperative 2-year recurrence rate decreased in early- and intermediate-stage HCC. |
| Author | Na, Hyo-Seok Lim, Dae-Jin Koo, Bon-Wook Oh, Ah-Young |
| AuthorAffiliation | Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea |
| AuthorAffiliation_xml | – name: Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea |
| Author_xml | – sequence: 1 givenname: Bon-Wook surname: Koo fullname: Koo, Bon-Wook – sequence: 2 givenname: Dae-Jin surname: Lim fullname: Lim, Dae-Jin – sequence: 3 givenname: Ah-Young surname: Oh fullname: Oh, Ah-Young – sequence: 4 givenname: Hyo-Seok surname: Na fullname: Na, Hyo-Seok email: *Dr. Hyo-Seok Na, Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, 82, Gumi 173, Bundang, Seongnam, Gyeonggi 13620 (South Korea), hsknana@gmail.com |
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| Cites_doi | 10.3748/wjg.v12.i16.2563 10.3748/wjg.v20.i20.5935 10.1186/s12967-014-0279-x 10.1093/bja/aet115 10.1126/science.1140485 10.1016/j.clim.2008.08.012 10.1002/hep.20969 10.1038/nature02924 10.1097/MOT.0000000000000243 10.1038/nrgastro.2010.213 10.1084/jem.192.12.1809 10.1016/j.cytogfr.2015.06.001 10.1196/annals.1338.030 10.1155/2016/7926264 10.1016/j.bja.2019.04.057 10.1097/ALN.0000000000001195 10.1038/bjc.2014.426 10.1007/s00270-019-02273-y 10.1111/j.1749-6632.2009.03704.x 10.1016/j.ejphar.2009.01.007 10.1213/ane.0b013e318160580b 10.1016/S0002-9440(10)64554-3 10.1016/j.surg.2006.06.028 10.1016/S1499-3872(13)60048-X 10.1016/j.intimp.2010.06.027 10.1097/01.sla.0000197706.21803.a1 |
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| Keywords | Anesthesia Hepatocellular carcinoma Propofol Hepatic resection Tumor progression Inhalation anesthetic |
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| References_xml | – reference: Berasain C, Castillo J, Perugorria MJ, Latasa MU, Prieto J, Avila MA. Inflammation and liver cancer: new molecular links. Ann N Y Acad Sci. 2009Feb;1155(1):206–21. 10.1111/j.1749-6632.2009.03704.x192502060077-8923 – reference: Vasileiou I, Xanthos T, Koudouna E, Perrea D, Klonaris C, Katsargyris A, et al.. Propofol: a review of its non-anaesthetic effects. Eur J Pharmacol. 2009Mar;605(1-3):1–8. 10.1016/j.ejphar.2009.01.007192482460014-2999 – reference: Huang H, Benzonana LL, Zhao H, Watts HR, Perry NJ, Bevan C, et al.. Prostate cancer cell malignancy via modulation of HIF-1α pathway with isoflurane and propofol alone and in combination. Br J Cancer. 2014Sep;111(7):1338–49. 10.1038/bjc.2014.426250722600007-0920 – reference: Dhanasekaran R, Limaye A, Cabrera R. Hepatocellular carcinoma: current trends in worldwide epidemiology, risk factors, diagnosis, and therapeutics. 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| SubjectTerms | General anesthesia Laparoscopy Liver cancer Medical personnel Metastasis Original Paper Patients Regression analysis Risk factors Surgery Survival analysis Tumor necrosis factor-TNF |
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| Title | Retrospective Comparison between the Effects of Propofol and Inhalation Anesthetics on Postoperative Recurrence of Early- and Intermediate-Stage Hepatocellular Carcinoma |
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