The Role of Perioperative Anesthetic Factors in NSCLC Survival

Perioperative anesthetic factors may affect the prognosis of patients with NSCLC following surgery, according to a study led by Wenzhi Zhu, MD.

Zhu and colleagues evaluated the association between the two in 588 patients who varied in NSCLC stage (stage I [45.1%], II [19.4%], III [27.4%], and IV [8.1%]). Patients were a median age of 61 years and underwent surgery from January 1, 2006, to December 31, 2009. OS was the primary end point, with postoperative RFS and postoperative pulmonary complications (PPCs) as secondary end points.

OS was 6.2 years and RFS was 4.4 years in this patient population. Advanced tumor stage, maximal tumor stage greater than 3 cm, and older age were associated with shorter survival. However, prolonged survival was seen in patients with high body mass index grade, high tumor grade, mediastinal lymph node dissection, and perioperative fentanyl equivalents >28.2 µg/kg.

In addition, perioperative glucocorticoid administration delayed recurrence. PPC risk was increased in patients with advanced tumor stage and perioperative fentanyl equivalents >28.2 µg/kg.

“Taken together, though there were no significant associations observed between other perioperative anesthetic factors such as anesthesia technique with patient outcomes in this study, the findings suggested that opioid and glucocorticoid exposure may affect the prognosis of patients with NSCLC after surgery anyway,” the study authors said.