Potential influence of anaesthesia techniques on the recurrence and progression after resection of non-muscle-invasive bladder cancer: a propensity score-matched analysis

Background: The non-muscle-invasive bladder cancer is a common malignancy of the urinary system. Many patients relapse after transurethral resection surgery. Different anaesthesia techniques may influence a patient's immune system during the perioperative time. In this study, we examined the effects of different anaesthesia techniques on the prognosis of primary non-muscle-invasive bladder cancer after transurethral resection surgery. Methods: In the period 2008 to 2017, a total of 926 patients suffered primary non-muscle-invasive bladder and underwent transurethral resection of bladder tumour surgery for the first time. These patients were divided into two groups according to the techniques that were used.There were 662 patients in the general anaesthesia group, who received propofol, opioid drugs (fentanyl family), non-depolarizing muscle relaxants, and sevoflurane, and 264 patients in the epidural anaesthesia group, who had an epidural catheter placed in the L2-L3 or L3-L4 interspace with a combination of lidocaine and ropivacaine or bupivacaine. We analyzed the influence factors that might affect prognosis and compared the recurrence-free survival time and the progression between the two groups. Results: The differences between the two groups in recurrence rate and progression rate were not statistically significant. Progression-free survival time of the epidural anaesthesia group was longer. Multivariate regression analysis showed that anaesthesia techniques were not independent influencing factors for recurrence and progression. Conclusions: It was not found that anaesthesia techniques affected the recurrence or progression of patients with primary non-muscle-invasive bladder cancer after transurethral resection of bladder tumour.