The Impact of Paravertebral Block Analgesia on Breast Cancer Survival After Surgery. Issue 6 (November 2016)

• Record Type: Journal Article
• Authors: Cata, Juan P.; Chavez-MacGregor, Mariana; Valero, Vicente; Black, Walter; Black, Daliah M.; Goravanchi, Farzin; Ifeanyi, Ifey C.; Hernandez, Mike; Rodriguez-Restrepo, Andrea; Gottumukkala, Vijaya
• Is Part Of: Regional anesthesia and pain medicine. Volume 41:Issue 6(2016)
• Publication Date: 2016-11
• Subjects: Conduction anesthesia -- Periodicals; Pain medicine -- Periodicals; 617.964
• DOI: 10.1097/AAP.0000000000000479
• Languages: English
• ISSNs: 1098-7339

Abstract

Abstract : Background and Objectives: The impact of regional anesthesia on breast cancer recurrence is controversial. We tested the hypothesis that the use of paravertebral block (PVB) analgesia during breast cancer surgery prolongs the recurrence-free survival (RFS) and overall survival (OS) of women with breast cancer. Methods: Seven hundred ninety-two women with nonmetastatic breast cancer were included in this retrospective study. Patients were divided based on the administration of PVB analgesia for mastectomy surgeries. One hundred ninety-eight (25%) were given a PVB, the remainder were treated with opioid-based analgesia. Propensity score matching was developed using several variables. Univariate and multivariate analyses were used to assess the impact of PVB analgesia on RFS and OS. Results: The median follow-up times for RFS and OS were 5.8 and 6 years, respectively. In the propensity score matching model, a total of 396 women were included in each group of treatment (non-PVB group, n = 198 vs PVB group, n = 198). As expected, the fentanyl consumption was significantly lower in PVB (122.8 ± 77.85 μg) patients than non-PVB subjects (402.23 ± 343.8 μg). Other variables were not statistically significant. After adjusting for several important covariates, the analysis indicated that the use of PVB is not associated with a significant change in RFS [1.60 (0.81–3.16), P = 0.172] or OS [1.28 (0.55–3.01)] survival. Discussion: This retrospective study does not support the hypothesis that the use of regional analgesia is associated with longer survival after surgery for breast cancer.