PMID- 37868870
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20231116
IS  - 2072-1439 (Print)
IS  - 2077-6624 (Electronic)
IS  - 2072-1439 (Linking)
VI  - 15
IP  - 9
DP  - 2023 Sep 28
TI  - Impact of anesthetic factors on prognosis of patients with non-small cell lung 
      cancer after surgery.
PG  - 4869-4884
LID - 10.21037/jtd-22-1812 [doi]
AB  - BACKGROUND: Nowadays, the influence of anesthesia management on the prognosis of 
      cancer patients has been widely concerned. The goal of this study is to assess 
      the association between anesthetic factors and the prognosis of patients with 
      non-small cell lung cancer (NSCLC) after surgery. METHODS: Patients with NSCLC 
      who underwent surgery from January 1, 2006, to December 31, 2009 were selected. 
      Cox proportional hazards model and Logistic regression analysis model were used 
      to screen the independent predictors of prognosis of patients. The primary 
      endpoint was postoperative overall survival (OS), and the secondary endpoint was 
      postoperative recurrence-free survival (RFS) and postoperative pulmonary 
      complications (PPCs). RESULTS: A total of 588 patients were included into the 
      final analysis. The overall RFS was 4.4 [interquartile range (IQR), 1.1-10.1] 
      years, and the OS was 6.2 (IQR, 2.4-10.2) years. Age >/=60 years, advanced tumor 
      stage, and maximal tumor size >3 cm were associated with shortened survival, 
      whereas high BMI grade, mediastinal lymph node dissection, perioperative fentanyl 
      equivalents >28.2 microg/kg, and high tumor grade were associated with prolonged 
      survival (P<0.05); perioperative glucocorticoid administration delayed recurrence 
      (P<0.05); advanced tumor stage and perioperative fentanyl equivalents >28.2 microg/kg 
      were associated with an increased PPCs risk (P<0.05). CONCLUSIONS: The findings 
      from this study revealed that perioperative anesthetic factors may impact the 
      prognosis of patients with NSCLC after surgery. Perioperative opioid and 
      glucocorticoid exposure were independent predictors for outcomes. However, 
      perioperative fentanyl equivalents over 28.2 microg/kg seemed to be beneficial to OS, 
      but contribute to the occurrence of PPCs.
CI  - 2023 Journal of Thoracic Disease. All rights reserved.
FAU - Zhu, Wenzhi
AU  - Zhu W
AD  - Key Laboratory of Carcinogenesis and Translational Research (Ministry of 
      Education/Beijing), Department of Anesthesiology, Peking University Cancer 
      Hospital & Institute, Beijing, China.
FAU - Li, Shuang
AU  - Li S
AD  - Department of Anesthesiology, Chines PLA General Hospital & Medical School, 
      Beijing, China.
FAU - Ji, Xinqiang
AU  - Ji X
AD  - Key Laboratory of Carcinogenesis and Translational Research (Ministry of 
      Education/Beijing), Department of medical record statistics, Peking University 
      Cancer Hospital & Institute, Beijing, China.
FAU - Tan, Hongyu
AU  - Tan H
AD  - Key Laboratory of Carcinogenesis and Translational Research (Ministry of 
      Education/Beijing), Department of Anesthesiology, Peking University Cancer 
      Hospital & Institute, Beijing, China.
LA  - eng
PT  - Journal Article
DEP - 20230621
PL  - China
TA  - J Thorac Dis
JT  - Journal of thoracic disease
JID - 101533916
CIN - J Thorac Dis. 2023 Oct 31;15(10):5272-5274. PMID: 37969287
PMC - PMC10586941
OTO - NOTNLM
OT  - Anesthetic factor
OT  - non-small cell lung cancer (NSCLC)
OT  - opioid
OT  - prognosis
COIS- Conflicts of Interest: All authors have completed the ICMJE uniform disclosure 
      form (available at 
      https://jtd.amegroups.com/article/view/10.21037/jtd-22-1812/coif). The authors 
      have no conflicts of interest to declare.
EDAT- 2023/10/23 06:46
MHDA- 2023/10/23 06:47
PMCR- 2023/09/28
CRDT- 2023/10/23 04:44
PHST- 2022/12/16 00:00 [received]
PHST- 2023/06/02 00:00 [accepted]
PHST- 2023/10/23 06:47 [medline]
PHST- 2023/10/23 06:46 [pubmed]
PHST- 2023/10/23 04:44 [entrez]
PHST- 2023/09/28 00:00 [pmc-release]
AID - jtd-15-09-4869 [pii]
AID - 10.21037/jtd-22-1812 [doi]
PST - ppublish
SO  - J Thorac Dis. 2023 Sep 28;15(9):4869-4884. doi: 10.21037/jtd-22-1812. Epub 2023 
      Jun 21.