Peridural analgesia does not impact survival in patients after colon cancer resection: a retrospective propensity score-adjusted analysis
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To assess the putative impact of peridural analgesia on oncological outcome in patients undergoing resection of stages I–IV colon cancer.
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.
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.
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.
KeywordsPeridural analgesia Colon cancer Overall survival Cancer-specific survival
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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