788 Influence of anaesthesiological technique on cancer control after radical prostatectomy (RP)

788 - Influence of anaesthesiological technique on cancer control after radical prostatecto... Page 1 of 2

e788 Influence of anaesthesiological technique on cancer control after radical prostatectomy (RP) 1

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Schiffmann J. , Roiss M. , Kessler T. , Tennstedt P. , Blanc I. , 2

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Reuter D. , Goetz A. , Thederan I. , Huland H. , Graefen M. 1

Martini-Klinik, Hamburg-Eppendorf University Hospital, Dept. of 2

Urology, Hamburg, Germany, Hamburg-Eppendorf University Hospital, Dept. of Anesthesiology, Center of Anesthesiology and Intensive Care Medicine, Hamburg, Germany INTRODUCTION & OBJECTIVES: Recently published studies on small patient cohorts suggest a possible association of cancer control rates and the anaesthesiological technique during surgery (general with regional vs. general anaesthesia). Additional regional anaesthesia reduces the dose of given opioids and neuroendocrine stress response, wich is affecting the immune system and give support to local and distant growth of malignant tissue. We therefore investigated the impact of anaestesiological technique in conjunction with established prognosticators of prostate cancer in a large patient cohort. MATERIAL & METHODS: Between 2002 and 2007 n=4259 consecutive patients underwent RP under regional/general or general anaesthesia alone. We investigated PSA-recurrence-free survival (PSA >0.2 ng/ml) in a univariate and multivariate Cox regression analysis including anaestehsiological characteristics such as dose of opioids, and general anaesthesia vs. general anaesthesia with additional regional anaesthesia (spinal anaesthesia) together with preoperative PSA level, pathologic stage and postoperative Gleasonscore. RESULTS: There was no association of dose of opioids and recurrence free survival in a univariate analysis (p=0.82). PSA recurrence free survival was in favour to general anaesthesia in a univariate (p=0.03) but not in a multivariate analysis (p=0.6) reflecting

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4/7/2012

788 - Influence of anaesthesiological technique on cancer control after radical prostatecto... Page 2 of 2

e788a a stage migration in more recent patients with more aggressive disease who mainly underwent regional anaesthesia. Preoperative PSA level, pT stage and Gleason-score however had a strong impact on recurrence free survival in the multivariate setting (p<0.0001). CONCLUSIONS: There seems to be no correlation between anaesthesiological technique and cancer control rates after radical prostatectomy.

file://F:\RamShankar\April\04-05-12\Cip\Sour\788.html

4/7/2012