Effects of intravenous anesthesia and inhalation anesthesia on postoperative inflammatory markers in patients with esophageal cancer: a retrospective study.

Background

Inflammatory markers have been confirmed to be associated with the prognosis of cancer patients. In this study, we compared the impacts of intravenous anesthesia and inhalation anesthesia on the neutrophil-to-lymphocyte ratio (NLR), the platelet-to-lymphocyte ratio (PLR), and the systemic immune-inflammation index (SII) after esophageal cancer surgery.

Methods

We retrospectively reviewed the electronic medical records of patients who underwent esophagectomy from January 1, 2014 to December 31, 2016. Patients respectively received total intravenous anesthesia (TIVA) or inhalational anesthesia (INHA). Inverse probability of treatment weighting (IPTW) was employed to minimize differences. The Mann-Whitney U test or Kruskal Wallis test was utilized to compare the effect of the two groups on postoperative NLR, PLR and SII.

Results

A total of 519 patients who had undergone esophageal cancer resection were recruited in this study, among whom 339 patients were eligible (TIVA group, n = 201, INHA group, n = 138). After IPTW, there was no statistically significant difference in NLR, PLR, and SII on the first postoperative day(P = 0.1951), (P = 0.5611), (P = 0.9684) and on the third postoperative day(P = 0.5961), (P = 0.1804), (P = 0.9653) between the two groups.

Conclusions

In conclusion, there was no significant difference in NLR, PLR and SII between intravenous anesthesia or inhalational anesthesia. TIVA is not superior to INHA in reducing the perioperative inflammatory response of esophageal cancer.

Synopsis

Inflammatory markers play an important role in the recurrence, metastasis and survival of tumor patients after surgery. In this study, we will compare the effects of different anesthesia methods on inflammatory markers.

COI Statement

Declarations. Ethics approval and consent to participate: This study was performed in accordance with the ethical principles of the Declaration of Helsinki. The study procedures were approved by the Ethics Committee of The Harbin Medical University Cancer Hospital. This is a retrospective study and individual informed consent to participate for this retrospective analysis with routine clinical data was waived by the Ethics Committee of The Harbin Medical University Cancer Hospital. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

References:

• Sung H, Ferlay J, Siegel RL, et al. Global Cancer statistics 2020: GLOBOCAN estimates of incidence and Mortality Worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2021;71(3):209–49.
• Arnold M, Ferlay J, van Berge Henegouwen MI, Soerjomataram I. Global burden of oesophageal and gastric cancer by histology and subsite in 2018. Gut. 2020;69(9):1564–71.
• Mariette C, Piessen G, Triboulet JP. Therapeutic strategies in oesophageal carcinoma: role of surgery and other modalities. Lancet Oncol. 2007;8(6):545–53.
• Hiller JG, Perry NJ, Poulogiannis G, Riedel B, Sloan EK. Perioperative events influence cancer recurrence risk after surgery. Nat Rev Clin Oncol. 2018;15(4):205–18.
• Wall T, Sherwin A, Ma D, Buggy DJ. Influence of perioperative anaesthetic and analgesic interventions on oncological outcomes: a narrative review. Br J Anaesth. 2019;123(2):135–50.