THE IMPACT OF ANESTHETIC TECHNIQUES ON TUMOR RECURRENCE IN CANCER SURGERY: A META-ANALYSIS ACROSS MULTIPLE ONCOLOGICAL SUBTYPES

Abstract

This meta-analysis investigates the impact of anesthetic techniques—regional anesthesia (RA) versus general anesthesia (GA)—on tumor recurrence across multiple oncological subtypes. A total of 32 studies, including randomized controlled trials, cohort, and case-control designs, were systematically analyzed, covering breast, prostate, colorectal, lung, and ovarian cancers. Data from over 15,000 patients were synthesized to evaluate recurrence rates, hazard ratios (HR), and methodological quality. RA and cancer were repeatedly associated with a risk of tumour recurrence that was lower than with GA in all cancer types.  The rate of cancer coming back was lower after surgery for breast cancer (8.2% vs. 12.5%) and colorectal cancer (12.7% vs. 17.4%) in the RA groups.  The combined hazard ratios for breast (HR = 0.74) and colorectal cancer (HR = 0.77) showed a notable drop in patients with RA.  Following the removal of studies with high risk of bias, additional testing showed the results were still valid.  The effect sizes in RCTs, cohort studies and case-control studies remained similar after being examined individually by design.  Most papers (more than 85%) showed a low risk in major research methods and there were no signs of severe imbalance or missing studies in the results of bias analysis.  They suggest that RA might reduce the chances of cancer coming back after surgery by possibly lowering perioperative immune system weakening, the level of inflammation, opioid intake and exposure to volatile anaesthetics.  This study justifies including RA in the multidisciplinary plan for oncologic surgeries even though larger trials need to confirm its cause and effect.  If anaesthetic planning is added to cancer treatment, it could be a simple and cost-effective approach to boost long-term satisfaction.