Positive Impact of Epidural Analgesia on Oncologic Outcomes in XXXX Undergoing Resection of Colorectal Liver Metastases.

@entity1 @entity4434 @entity1349
INTRODUCTION: Previous studies have suggested that the use of regional anesthesia can reduce recurrence risk after oncologic surgery. The purpose of this study was to assess the effect of epidural anesthesia on recurrence-free ( @entity4434 ) and @entity1349 ( @entity1349 ) after hepatic resection for colorectal liver metastases (CLM). METHODS: After approval of the institutional review board, the records of all adult @entity1 who underwent elective hepatic resection between January 2006 and October 2011 were retrospectively reviewed. @entity1 were categorized according to use of perioperative epidural analgesia versus intravenous analgesia. Univariate and multivariate analyses were performed to identify factors influencing @entity4434 and @entity1349 . RESULTS: Of 510 total @entity1 , 390 received epidural analgesia (EA group) and 120 @entity1 received intravenous analgesia (IVA group). Compared with the IVA group, more @entity1 in the EA group underwent associated surgical procedures with consequently longer operative times (p  <  0.001). In addition, the EA group received more intraoperative fluids and had higher urine output volumes (p   <=  0.001). Five-year @entity4434 was longer in the EA group (34.7  %) compared with the IVA group (21.1  %). On multivariate analysis, the receipt of epidural analgesia was an independent predictor of improved @entity4434 (p  =  0.036, hazard ratio [HR] 0.74; 95  % confidence interval [CI] 0.56-0.95), but not @entity1349 (p  =  0.102, HR 0.72; 95  % CI 0.49-1.07). CONCLUSIONS: This study suggests an association between epidural analgesia and improved @entity4434 , but not @entity1349 , after CLM resection. These results warrant further prospective, randomized studies on the benefits of regional anesthesia on oncologic outcomes after hepatic resection for CLM.
