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International Journal of Colorectal Disease

, Volume 34, Issue 7, pp 1283–1293 | Cite as

Peridural analgesia does not impact survival in patients after colon cancer resection: a retrospective propensity score-adjusted analysis

  • Elena F. Wurster
  • Frank Pianka
  • Rene Warschkow
  • Pia Antony
  • Thorsten Brenner
  • Markus A. Weigand
  • Bruno M. Schmied
  • Markus W. Büchler
  • Ignazio TarantinoEmail author
  • Alexis Ulrich
Original Article
  • 32 Downloads

Abstract

Purpose

To assess the putative impact of peridural analgesia on oncological outcome in patients undergoing resection of stages I–IV colon cancer.

Methods

In a single-center study, 876 patients undergoing resection for primary colon cancer (AJCC stages I–IV) between 2001 and 2014 were analyzed. Mean follow-up of the entire cohort was 4.2 ± 3.5 years. Patients who did and did not receive peridural analgesia were compared using Cox regression and propensity score analyses.

Results

Overall, 208 patients (23.7%) received peridural analgesia. Patients’ characteristics were biased with regard to the use of peridural analgesia (propensity score 0.296 ± 0.129 vs. 0.219 ± 0.108, p < 0.001). After propensity score matching, the use of peridural analgesia had no impact on overall (HR 0.81, 95% CI 0.59–1.11, p = 0.175), cancer-specific (HR 0.72, 95% CI 0.48–1.09, p = 0.111), and disease-free survival (HR 0.89, 95% CI 0.66–1.19, p = 0.430). The 5-year overall survival after propensity score matching was 60.9% (95% CI 54.8–67.7%) for patients treated with peridural analgesia compared with 54.1% (95% CI 49.5–59.1%) for patients not treated with peridural analgesia. Cancer-specific and disease-free survival showed similar non-significant results.

Conclusions

Peridural analgesia in patients after colon cancer resection was not associated with a better oncological outcome after risk adjusting in multivariable Cox regression and propensity score analyses. Hence, oncological outcome should not serve as a reason for the use of peridural analgesia in patients with colon cancer.

Keywords

Peridural analgesia Colon cancer Overall survival Cancer-specific survival 

Notes

Funding

The study did not receive any funding.

Compliance with ethical standards

An independent ethics committee at the University Heidelberg approved the present study (S-649/2012).

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Elena F. Wurster
    • 1
  • Frank Pianka
    • 1
  • Rene Warschkow
    • 2
    • 3
  • Pia Antony
    • 1
  • Thorsten Brenner
    • 4
  • Markus A. Weigand
    • 4
  • Bruno M. Schmied
    • 2
  • Markus W. Büchler
    • 1
  • Ignazio Tarantino
    • 2
    Email author
  • Alexis Ulrich
    • 5
  1. 1.Department of General, Visceral and Transplantation SurgeryUniversity Hospital HeidelbergHeidelbergGermany
  2. 2.Department of General, Visceral, Endocrine and Transplantation SurgeryKantonsspital St. GallenSt. GallenSwitzerland
  3. 3.Institute of Medical Biometry and InformaticsUniversity of HeidelbergHeidelbergGermany
  4. 4.Department of AnesthesiologyUniversity Hospital HeidelbergHeidelbergGermany
  5. 5.Surgical Department IStädtische Kliniken Neuss Lukaskrankenhaus GmbH, Lukaskrankenhaus GmbHNeussGermany

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