The Effects of Perioperative Regional Anesthesia and Analgesia on Cancer Recurrence and Survival After Oncology Surgery A Systematic Review and Meta-Analysis

Background and Objectives: Potentially, perioperative regional anesthesia and analgesia (RA) could influence the outcomes of patients with cancer. The aim of this systematic review and meta-analysis was to evaluate the effects of perioperative RA on survival and cancer recurrence after oncologic surgery. Methods: The authors searched computerized databases (from inception to December 2014) and reference lists and considered all studies comparing the effects of RA on cancer recurrence or overall survival with that of general anesthesia (GA). Risk estimates were pooled to determine the effects of RA on risks of cancer recurrence and mortality. Twenty eligible studies were included. Results: Perioperative RA use was associated with improved overall survival (Hazard ratio [HR] = 0.84, 95% CI, 0.75 - 0.94; I-2 = 41%), but not with reduced cancer recurrence (HR = 0.91, 95% CI, 0.70 - 1.18; I-2 = 83%). Conclusions: Our meta-analysis suggests that RA may improve overall survival but not reduce cancer recurrence after oncologic surgery.