title: Association between preoperative glucocorticoids and long-term survival and cancer recurrence after colectomy: follow-up analysis of a previous randomized controlled trial.
abstract: BACKGROUND
  The effect of anaesthetic drugs on long-term oncological outcomes after cancer surgery is an area of current interest. Dexamethasone is widely used in anaesthetic practice; however, its effect on long-term survival and cancer outcomes is not known. This study presents the results of a 5-yr follow-up of patients receiving dexamethasone before elective colectomy as part of a previous randomized clinical trial.
  
  
  METHODS
  Sixty patients who underwent elective open colonic resection for any indication between June 2006 and March 2008 were randomized to receive either 8 mg i.v. dexamethasone or placebo before surgery. A 5-yr follow-up analysis was conducted to evaluate overall survival, disease-free survival and recurrence specifically for patients undergoing resection for Stage I-III colon cancer. Kaplan-Meier analysis was performed and log-rank test was used to evaluate difference in survival between groups.
  
  
  RESULTS
  Forty-three of the 60 subjects had Stage I-III colon cancer and were included in the follow-up analysis. Twenty received preoperative dexamethasone and 23 received placebo. There were no significant differences between groups in baseline or disease characteristics. No differences were found between groups for overall or disease-free survival. In the dexamethasone group, there was a significantly higher rate of distant recurrence (6 compared with 1, P=0.04).
  
  
  CONCLUSIONS
  Preoperative dexamethasone was associated with a higher rate of distant recurrence in patients undergoing colectomy for colon cancer. Given the small sample size, this finding should be interpreted with caution, but warrants further investigation in a prospective study.
authors.affiliation: Faculty of Medical and Health Sciences, Department of Surgery, South Auckland Clinical School, University of Auckland, Auckland, New Zealand dr.parrysingh@gmail.com.
authors.forename: P P
authors.initials: PP
authors.lastname: Singh
authors.affiliation: Faculty of Medical and Health Sciences, Department of Surgery, South Auckland Clinical School, University of Auckland, Auckland, New Zealand.
authors.forename: D P
authors.initials: DP
authors.lastname: Lemanu
authors.affiliation: Department of Anaesthesia, Middlemore Hospital, Counties Manukau District Health Board, Auckland, New Zealand.
authors.forename: M H G
authors.initials: MH
authors.lastname: Taylor
authors.affiliation: Faculty of Medical and Health Sciences, Department of Surgery, South Auckland Clinical School, University of Auckland, Auckland, New Zealand.
authors.forename: A G
authors.initials: AG
authors.lastname: Hill
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003082:Colectomy / Q000009:adverse effects; D003110:Colonic Neoplasms / Q000473:pathology / Q000601:surgery*; D003907:Dexamethasone / Q000009:adverse effects*; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000009:adverse effects*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D011229:Preanesthetic Medication / Q000379:methods
chemical_list: D005938:Glucocorticoids; D003907:Dexamethasone
keywords: colectomy; colonic neoplasms; dexamethasone; neoplasm metastasis; recurrence