Title:
Cancer-free or overall survival rate following radical prostatectomy is not influenced by perioperative pain management. A retrospective comparison of intravenous patient-controlled analgesia vs. epidural analgesia
Background and Goal of Study:
There is controversial data regarding influence of anaesthetic techniques on the outcome of patients undergoing cancer surgery. In particular, whether patients benefit from the application of regional techniques is elaborately discussed. Therefore, we enrolled a retrospective analysis to determine the influence of different anaesthetic techniques in patients who underwent radical prostatectomy due to prostate cancer.
Materials and Methods:
After ethics approval, we viewed our medical record archive for patients that received radical prostatectomy between 1995 and 2005 and included 300 patients. They were divided according to their postoperative pain regime (systemic opioids vs. epidural analgesia). Recurrence-free survival was defined as the primary endpoint and overall survival as the secondary endpoint. The study period covered at least the first five post-operative years.
Results and Discussion:
We documented no difference in recurrence-free or overall survival comparing the two analgesic regimes. However, we observed that higher body-mass-indexes (BMI) significantly correlated with a worse outcome (recurrence-free survival p=0.037, overall survival p=0.02). Other factors influencing the outcome were the Gleason score (5-6 vs. 10 p=0.016; 7 vs. 10 p=0.08) and surgical margins free of cancer (p=0.04).
Conclusion(s):
In this study, different anaesthetic techniques did not influence recurrence-free or overall survival rate. Interestingly, we could identify BMI as a risk factor with potential impact on the outcome of patients undergoing radical prostatectomy. Adequately powered prospective randomized trials are required to decide on the effect of regional anaesthesia in patients who underwent radical prostatectomy.


03 / Cancer-free or overall survival rate following radical prostatectomy is not influenced by perioperative pain management. A retrospective comparison of intravenous patient-controlled analgesia vs. epidural analgesia