Anaesthetic technique may affect prognosis for ovarian serous adenocarcinoma: a retrospective analysis

Animal studies have shown that regional anaesthesia and analgesia may prevent or attenuate the surgical stress response by preserving immune function and result in better long-term outcome. We have tested the hypothesis that patients with ovarian serous adenocarcinoma who had surgery with epidural anaesthesia and analgesia would have better long-term outcome than those who were given general anaesthesia (GA) and i.v. opioid analgesia.

A retrospective review of medical records identified 143 patients with ovarian serous adenocarcinoma who underwent surgery between January 1994 and October 2006 at the Sun Yat-sen University Cancer Center. Data in the analysis included age, anaesthesia-analgesia technique, ASA status, blood loss, transfusion, duration of surgery, status of preoperative cancer antigen 125, tumour size, International Federation of Gynecology and Obstetrics stage, histological grade, lymph node status, residual macroscopic tumour, and chemotherapy. Survival analysis was made with the main outcome measure of death.

The 3- and 5-yr overall survival rates were 78% and 61% in the patient group who received epidural anaesthesia and analgesia (Group E, n=106), and 58% and 49% in the patient group who received GA and i.v. opioid analgesia (Group G, n=37), respectively. After adjusting for the other variables, Group G had a hazard ratio of 1.214 (P=0.043) in a multivariable Cox regression model compared with Group E.

This retrospective analysis suggests that epidural anaesthesia and analgesia for ovarian serous adenocarcinoma surgery may reduce mortality during the initial years of follow-up.