Kan valet av anestesimedel påverka överlevnaden efter cancerkirurgi?

Tidsperiod: 2013-01-01 till 2015-12-31

Finansiär: Vetenskapsrådet

Bidragstyp: Projektbidrag

Budget: 2 775 000 SEK

Background: A recent retrospective analysis of 2,173 patients indicated that 5-year survival may differ up to 5% depending on the choice of anaesthetic. Sevoflurane, an inhalational anaesthetic, is pro-inflammatory and genotoxic, whereas the intravenous anaesthetic propofol is anti-inflammatory, anti-oxidative, and non-genotoxic. Hypotheses: We hypothesize that one- and five-year survival after radical breast-, and colorectal cancer surgery in general anaesthesia is significantly higher in patients given propofol compared with those given sevoflurane. Significance: General anaesthesia is an indispensable part of radical cancer surgery. Undesired effects from anaesthesia on survival have strong relevance for the overall cancer treatment. Method: Six Swedish centres shall recruit 4,000 patients. The power estimation is based on the results from our retrospective study. Patients will after informed consent be randomised to either anaesthesia with sevoflurane or with propofol. Cumulative 1- and 5-year overall survival will be assessed using the Kaplan Meier method and the estimates will be compared between patients given sevoflurane or propofol. Cox Proportional hazard models will be calculated to assess the risk of death adjusted for potential effect modifiers and confounders. Expected results: We expect that survival in patients anaesthetised with propofol will be significantly higher at a clinically significant rate compared with patients anaesthetised with sevoflurane.