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Research article
Weifeng Yu
second military medical university
Corresponding Author
ORCiD: https://orcid.org/0000-0002-4349-347X
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This work is licensed under a CC BY 4.0 License. Read Full License
Background Whether anesthesia type is associate with the surgical outcome of Hepatocellular carcinoma (HCC) patients with portal vein tumor thrombus (PVTT) remains to be determined. This study aims to investigate the impact of volatile inhalational anesthesia (INHA) versus total IV anesthesia (TIVA) on the survival outcomes in HCC patients with PVTT.
Methods A cohort of in-patients whom were diagnosed of HCC with PVTT in Eastern Hepatobiliary Surgery Hospital, Shanghai, China, from January 1, 2008 to December 24, 2012 were identified. Surgical patients receiving the INHA and TIVA were screened out. The overall survival (OS), recurrence-free survival (RFS) and several postoperative adverse events were compared according to anesthesia types.
Results A total of 1513 patients were included in this study. After exclusions are applied, 263 patients remain in the INHA group and 208 in the TIVA group. Patients receiving INHA have a lower 5-year overall survival rate than that of patients receiving TIVA [12.6% (95% CI, 9.0 to 17.3) vs. 17.7% (95% CI, 11.3 to 20.8), P=0.024]. Results of multivariable Cox-regression analysis also identify that INHA anesthesia is significantly associated with mortality and cancer recurrence after surgery compare to TIVA, with HR (95%CI) of 1.303 (1.065, 1.595) and 1.265 (1.040, 1.539), respectively. Subgroup analysis suggested that in more severe cancer patients, the worse outcome related to INHA might be more significant.
Conclusion This retrospective analysis identifies that TIVA has better survival outcomes compare to INHA in HCC patients with PVTT. Future prospective researches are urgent to verify this difference and figure out underlying causes of it.
Keywords
Hepatocellular Carcinoma, Portal Vein Tumor Thrombus, volatile inhalational anesthesia, total IV anesthesia
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CURRENT STATUS: Published
View the published article at BMC Anesthesiology.
Version 2
Posted 20 Feb, 2020
No community comments so far
Editorial decision: Minor revision
On 02 Jun, 2020
Review #1 received
Received 15 Mar, 2020
Reviewer #2 agreed
On 21 Feb, 2020
Reviewer #1 agreed
On 20 Feb, 2020
Reviewers invited
Invitations sent on 20 Feb, 2020
Editor assigned
On 19 Feb, 2020
Submission checks complete
On 18 Feb, 2020
Editor invited
On 18 Feb, 2020
No comments provided
Editorial decision: Major revision
On 10 Jan, 2020
Review #3 received
Received 02 Jan, 2020
Reviewer #3 agreed
On 17 Dec, 2019
Review #2 received
Received 27 Nov, 2019
Reviewer #2 agreed
On 19 Nov, 2019
Review #1 received
Received 15 Nov, 2019
Reviewer #1 agreed
On 10 Nov, 2019
Reviewers invited
Invitations sent on 06 Nov, 2019
Editor assigned
On 16 Oct, 2019
Submission checks complete
On 07 Oct, 2019
Editor invited
On 07 Oct, 2019
First submitted
On 22 Sep, 2019
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Anesthesiology & Pain Medicine
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A new preprint design is coming!
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See the published version of this preprint at BMC Anesthesiology.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Weifeng Yu
second military medical university
Corresponding Author
ORCiD: https://orcid.org/0000-0002-4349-347X
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at BMC Anesthesiology.
Version 2
Posted 20 Feb, 2020
No community comments so far
Editorial decision: Minor revision
On 02 Jun, 2020
Review #1 received
Received 15 Mar, 2020
Reviewer #2 agreed
On 21 Feb, 2020
Reviewer #1 agreed
On 20 Feb, 2020
Reviewers invited
Invitations sent on 20 Feb, 2020
Editor assigned
On 19 Feb, 2020
Submission checks complete
On 18 Feb, 2020
Editor invited
On 18 Feb, 2020
No comments provided
Editorial decision: Major revision
On 10 Jan, 2020
Review #3 received
Received 02 Jan, 2020
Reviewer #3 agreed
On 17 Dec, 2019
Review #2 received
Received 27 Nov, 2019
Reviewer #2 agreed
On 19 Nov, 2019
Review #1 received
Received 15 Nov, 2019
Reviewer #1 agreed
On 10 Nov, 2019
Reviewers invited
Invitations sent on 06 Nov, 2019
Editor assigned
On 16 Oct, 2019
Submission checks complete
On 07 Oct, 2019
Editor invited
On 07 Oct, 2019
First submitted
On 22 Sep, 2019
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Anesthesiology & Pain Medicine
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at BMC Anesthesiology.
Background Whether anesthesia type is associate with the surgical outcome of Hepatocellular carcinoma (HCC) patients with portal vein tumor thrombus (PVTT) remains to be determined. This study aims to investigate the impact of volatile inhalational anesthesia (INHA) versus total IV anesthesia (TIVA) on the survival outcomes in HCC patients with PVTT.
Methods A cohort of in-patients whom were diagnosed of HCC with PVTT in Eastern Hepatobiliary Surgery Hospital, Shanghai, China, from January 1, 2008 to December 24, 2012 were identified. Surgical patients receiving the INHA and TIVA were screened out. The overall survival (OS), recurrence-free survival (RFS) and several postoperative adverse events were compared according to anesthesia types.
Results A total of 1513 patients were included in this study. After exclusions are applied, 263 patients remain in the INHA group and 208 in the TIVA group. Patients receiving INHA have a lower 5-year overall survival rate than that of patients receiving TIVA [12.6% (95% CI, 9.0 to 17.3) vs. 17.7% (95% CI, 11.3 to 20.8), P=0.024]. Results of multivariable Cox-regression analysis also identify that INHA anesthesia is significantly associated with mortality and cancer recurrence after surgery compare to TIVA, with HR (95%CI) of 1.303 (1.065, 1.595) and 1.265 (1.040, 1.539), respectively. Subgroup analysis suggested that in more severe cancer patients, the worse outcome related to INHA might be more significant.
Conclusion This retrospective analysis identifies that TIVA has better survival outcomes compare to INHA in HCC patients with PVTT. Future prospective researches are urgent to verify this difference and figure out underlying causes of it.
Figure 1
Figure 2
Figure 3
Figure 4
Figure 5
Figure 6
This is a list of supplementary files associated with this preprint. Click to download.
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