Prognostic value of anesthesia type for patients treated for cutaneous melanoma.
BACKGROUND
General anesthesia has been reported to compromise several cell-mediated immune functions. Hence it is plausible that anesthesia could affect the postoperative outcome of cancer patients.


OBJECTIVE
To study the influence of the type of anesthesia on survival of 459 patients with localized cutaneous melanoma observed between 1980 and 1991.


METHODS
Crude survival proportions were calculated by the methods of Kaplan and Meier. Cox proportional hazards regression analysis was used to estimate the effect on death rates of the type of anesthesia.


RESULTS
The 5-year survival proportions were 81% for patients treated under local anesthesia, 71.9% for patients receiving halothane isoflurane or enflurane, and 88.4% for neuroleptanalgesia (P < .05). After multiple adjustment for other prognostic variables (tumor thickness, presence of ulceration, age, sex, cross-sectional profile), using patients treated under local anesthesia as a reference group, the relative risk for general anesthesia with volatile agents was 1.3 (95% CI, 0.84-2.10).


CONCLUSIONS
The type of anesthesia does not seem to affect the survival of patients with cutaneous melanoma, when other prognostic factors are considered.
Melchi
C F
CF
Instituto Dermopatico dell'Immacolata, (IDI-IRCCS), Rome, Italy.
Mele
A
A
Baliva
G
G
Sciò
M
M
Fucci
M
M
Pasquini
P
P
Corona
R
R
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000768:Anesthesia, General; D000769:Anesthesia, Inhalation; D000772:Anesthesia, Local; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008545:Melanoma / Q000473:pathology / Q000601:surgery*; D008875:Middle Aged; D009458:Neuroleptanalgesia; D011379:Prognosis; D016016:Proportional Hazards Models; D012044:Regression Analysis; D012737:Sex Factors; D012878:Skin Neoplasms / Q000473:pathology / Q000601:surgery*; D012883:Skin Ulcer / Q000473:pathology; D015996:Survival Rate; D016896:Treatment Outcome