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The Impact of Paravertebral Block Analgesia on Breast Cancer Survival After Surgery
Juan P Cata1, Mariana Chavez-MacGregor, Vicente Valero
1From the *Department of Anesthesiology and Perioperative Medicine, The University of Texas MD Anderson Cancer Center; †Anesthesiology and Surgical Oncology Research Group; and Departments of ‡Breast Medical Oncology, §Breast Surgical Oncology, and ∥Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX.
Background And Objectives:
The impact of regional anesthesia on breast cancer recurrence is controversial. We tested the hypothesis that the use of paravertebral block (PVB) analgesia during breast cancer surgery prolongs the recurrence-free survival (RFS) and overall survival (OS) of women with breast cancer.
Methods:
Seven hundred ninety-two women with nonmetastatic breast cancer were included in this retrospective study. Patients were divided based on the administration of PVB analgesia for mastectomy surgeries. One hundred ninety-eight (25%) were given a PVB, the remainder were treated with opioid-based analgesia. Propensity score matching was developed using several variables. Univariate and multivariate analyses were used to assess the impact of PVB analgesia on RFS and OS.
Results:
The median follow-up times for RFS and OS were 5.8 and 6 years, respectively. In the propensity score matching model, a total of 396 women were included in each group of treatment (non-PVB group, n = 198 vs PVB group, n = 198). As expected, the fentanyl consumption was significantly lower in PVB (122.8 ± 77.85 μg) patients than non-PVB subjects (402.23 ± 343.8 μg). Other variables were not statistically significant. After adjusting for several important covariates, the analysis indicated that the use of PVB is not associated with a significant change in RFS [1.60 (0.81-3.16), P = 0.172] or OS [1.28 (0.55-3.01)] survival.
Discussion:
This retrospective study does not support the hypothesis that the use of regional analgesia is associated with longer survival after surgery for breast cancer.
