title: Regional anesthesia/analgesia and the risk of cancer recurrence and mortality after prostatectomy: a meta-analysis.
abstract: OBJECTIVE
  To determine whether the use neuraxial anesthesia/analgesia is associated with longer biochemical recurrence-free survival (BRFS) and overall survival (OS) after radical prostatectomy.
  
  
  METHODS
  Ten studies were included in the meta-analysis. A random-effects model was used to estimate the hazard ratios (HRs).
  
  
  RESULTS
  The HR for BRFS was 1.02 (95% CI: 0.91-1.15) for all studies and 1.08 (95% CI: 0.91-1.15) for those that included propensity score matching. For OS, the HR across all studies was 0.91 (95% CI: 0.7-1.15) and 0.81 (95% CI: 0.68-0.96; p = 0.016) for those reporting propensity score matching.
  
  
  CONCLUSIONS
  The anesthetic technique used during oncologic prostatectomy surgery is not associated with longer BRFS. By contrast, the use of regional analgesia appears to improve OS.
authors.affiliation: Department of General Surgery, John Hopkins Hospital, MD, USA.
authors.forename: Brenda M
authors.initials: BM
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Nassau University Medical Center, East Meadow, NY 11554, USA.
authors.forename: Vinny
authors.initials: V
authors.lastname: Singh Ghotra
authors.affiliation: Department of Urology, University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: Jose A
authors.initials: JA
authors.lastname: Karam
authors.affiliation: Department of Biostatistics, University of Texas MD Anderson Cancer Center, PO Box 301402 Houston, TX 77230-1402, USA.
authors.forename: Mike
authors.initials: M
authors.lastname: Hernandez
authors.affiliation: Research Medical Library, University of Texas MD Anderson Cancer Center, Houston, TX 77230-1402, USA.
authors.forename: Greg
authors.initials: G
authors.lastname: Pratt
authors.affiliation: Department of General Surgery, John Hopkins Hospital, MD, USA.|Anesthesia & Surgical Oncology Research Group, Houston, TX 77030, USA.
authors.forename: Juan P
authors.initials: JP
authors.lastname: Cata
mesh_terms: D015360:Analgesia, Epidural; D000767:Anesthesia, Epidural; D000775:Anesthesia, Spinal; D018572:Disease-Free Survival; D006801:Humans; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000601:surgery; D016016:Proportional Hazards Models; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000401:mortality* / Q000601:surgery*; D012307:Risk Factors; D016896:Treatment Outcome
keywords: biochemical recurrence-free survival; overall survival; prostate cancer; regional anesthesia