Spinal Anesthesia is Associated with Lower Recurrence Rates after Resection of Nonmuscle Invasive Bladder Cancer

Area of Science:

• Urology
• Anesthesiology
• Oncology

Background:

• Transurethral resection of bladder tumors (TURBT) is a standard procedure for nonmuscle invasive urothelial bladder cancer.
• The choice of anesthetic may influence postoperative outcomes, including cancer recurrence.

Purpose of the Study:

• To investigate the association between anesthetic type (general vs. spinal) and cancer recurrence after TURBT.
• To determine if anesthetic choice impacts the time to first recurrence and overall recurrence rates.

Main Methods:

• Retrospective review of 231 patients undergoing TURBT for nonmuscle invasive bladder cancer (2011-2013).
• Comparison of recurrence incidence and time to recurrence between patients receiving spinal anesthesia (n=135) and general anesthesia (n=96).
• Multivariable analyses adjusted for risk stratification and adjuvant therapies.

Main Results:

• Spinal anesthesia was associated with a longer median time to recurrence (42.1 vs. 17.2 months) and a lower incidence of recurrence on multivariable analysis (OR 2.06, p=0.017).
• General anesthesia was linked to a higher incidence and earlier time to recurrence (HR 1.57, p=0.008).
• Adjuvant therapies and risk category also significantly influenced recurrence rates.

Conclusions:

• Spinal anesthesia may be associated with a reduced risk of bladder cancer recurrence after TURBT.
• These findings suggest a potential protective effect of spinal anesthesia that warrants further investigation.
• Large-scale prospective studies are recommended to validate these results.