Comparison of biochemical recurrence after robot-assisted laparoscopic radical prostatectomy with volatile and total intravenous anesthesia

Na Young Kim, Won Sik Jang, Young Deuk Choi, Jung Hwa Hong, Sewon Noh, Young Chul Yoo

Research output: Contribution to journalArticle

Abstract

Aims: Recurrence after cancer surgery is a major concern in patients with cancer. Growing evidence from preclinical studies has revealed that various anesthetics can influence the immune system in different ways. The current study compared the long-term biochemical recurrence of prostate cancer after robot-assisted laparoscopic radical prostatectomy (RALP) in terms of selection of anesthetic agent between total intravenous anesthesia (TIVA) with propofol/remifentanil and volatile anesthetics (VA) with sevoflurane or desflurane/remifentanil. Methods: We followed up oncologic outcomes of patients who underwent RALP from two previous prospective randomized controlled trials, and the outcomes of those who received TIVA (n = 64) were compared with those who received VA (n = 64). The follow-up period lasted from November 2010 to March 2019. Results: Both TIVA and VA groups showed identical biochemical recurrence-free survivals at all-time points after RALP. The following predictive factors of prostate cancer recurrence were determined by Cox regression: colloid input [hazard ratio (HR)=1.002, 95% confidence interval (CI): 1.000–1.003; P = 0.011], initial prostate-specific antigen level (HR=1.025, 95% CI: 1.007–1.044; P = 0.006), and pathological tumor stage 3b (HR=4.217, 95% CI:1.207–14.735; P = 0.024), but not the anesthetic agent. Conclusions: Our findings demonstrate that both TIVA with propofol/remifentanil and VA with sevoflurane or desflurane/remifentanil have comparable effects on oncologic outcomes in patients undergoing RALP.

Original languageEnglish
Pages (from-to)449-456
Number of pages8
JournalInternational Journal of Medical Sciences
Volume17
Issue number4
DOIs
Publication statusPublished - 2020 Jan 1

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Fingerprint Dive into the research topics of 'Comparison of biochemical recurrence after robot-assisted laparoscopic radical prostatectomy with volatile and total intravenous anesthesia'. Together they form a unique fingerprint.

  • Cite this