title: Perioperative Paravertebral Regional Anaesthesia and Breast Cancer Recurrence.
abstract: OBJECTIVE
  Retrospective and basic science data suggest that perioperative regional anaesthesia (PRA) may reduce tumour recurrence after cancer surgery. This retrospective archive study tested the anti-metastatic effect of PRA.
  
  
  METHODS
  We screened the database of the Helsinki University Hospital for patients with breast cancer who had either perioperative paravertebral block (PVB) or sham block (SHAM) in 2000-2003. The exclusion criteria were previous cancer, no cancer, and loss to follow-up. The end-points were disease-free (DFS), distant recurrence-free (DRFS), breast cancer-specific (BCSS) and overall (OS) survival.
  
  
  RESULTS
  The median follow-up time of the 45 PVB and 41 SHAM patients analysed was 12 years. DFS was 79% and 83%, DRFS 84% and 92%, BCSS 81% and 95%, OS 74% and 93% in the PVB and SHAM groups, respectively (p-value for OS = 0.035).
  
  
  CONCLUSIONS
  The results do not demonstrate any anti-metastatic effect of PRA.
authors.affiliation: Division of Perioperative, Intensive Care and Pain Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland pekka.kairaluoma@hus.fi.
authors.forename: Pekka
authors.initials: P
authors.lastname: Kairaluoma
authors.affiliation: Department of Oncology, Division of Comprehensive Cancer Centre, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
authors.forename: Johanna
authors.initials: J
authors.lastname: Mattson
authors.affiliation: Department of Pathology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
authors.forename: Päivi
authors.initials: P
authors.lastname: Heikkilä
authors.affiliation: Division of Perioperative, Intensive Care and Pain Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
authors.forename: Pertti
authors.initials: P
authors.lastname: Pere
authors.affiliation: Breast Surgery Unit, Division of Comprehensive Cancer Centre, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
authors.forename: Marjut
authors.initials: M
authors.lastname: Leidenius
mesh_terms: D000765:Anesthesia, Conduction / Q000379:methods*; D001943:Breast Neoplasms / Q000601:surgery*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D012189:Retrospective Studies
keywords: Breast carcinoma; bupivacaine; paravertebral block; recurrence; regional anaesthesia; survival