title: A comparison of regional and general anesthesia effects on 5 year survival and cancer recurrence after transurethral resection of the bladder tumor: a retrospective analysis.
abstract: BACKGROUND
  Recent studies have reported that cancer surgeries involving regional anesthesia have better outcomes than those under general anesthesia. However, the effects of anesthetic technique have not been investigated in patients with bladder cancer. Therefore, this retrospective study was conducted to investigate which anesthetic technique results in a better bladder cancer prognosis.
  
  
  METHODS
  Sixty-one of 531 patients underwent transurethral resection of a bladder tumor under general anesthesia from 2001 to 2008 in our hospital. Patients who attended five years of follow-up and who had pathological findings of urothelial carcinoma grades I-II were enrolled. Finally, 24 patients (G group) who underwent general anesthesia and 137 (R group) who underwent regional (spinal or epidural) anesthesia were compared. Five-year survival and recurrence-free time were compared using the chi-square and t-tests, respectively. A logistic regression and partial correlation analysis were performed to evaluate other factors affecting survival.
  
  
  RESULTS
  Five-year survival was 87.5% for general anesthesia and 96.3% for regional (P = 0.099). The regression analysis showed that older age contributed to reduced survival (odds ratio = 0.85, P = 0.001). Regional anesthesia showed higher 5-year survival (coefficient = -0.167, P = 0.044) more than general anesthesia through the partial correlation analysis.
  
  
  CONCLUSIONS
  Though partial correlation analysis show that five-year survival is higher in patients whose surgery is under regional than general anesthesia, the association was not significant in the chi-square test and logistic regression analysis. Large prospective studies are needed to determine whether the association between regional anesthesia and survival is causative.
authors.affiliation: Department of Anesthesiology and Pain Medicine, Chungnam National University Hospital, Daejeon, Korea.
authors.forename: Dale
authors.initials: D
authors.lastname: Jang
authors.affiliation: Department of Anesthesiology and Pain Medicine, Chungnam National University Hospital, Daejeon, Korea. limtwo2@gmail.com.
authors.forename: Chae Seong
authors.initials: CS
authors.lastname: Lim
authors.affiliation: Department of Anesthesiology and Pain Medicine, Chungnam National University Hospital, Daejeon, Korea.
authors.forename: Yong Sup
authors.initials: YS
authors.lastname: Shin
authors.affiliation: Department of Anesthesiology and Pain Medicine, Chungnam National University Hospital, Daejeon, Korea.
authors.forename: Young Kwon
authors.initials: YK
authors.lastname: Ko
authors.affiliation: Department of Anesthesiology and Pain Medicine, Chungnam National University Hospital, Daejeon, Korea.
authors.forename: Sang Il
authors.initials: SI
authors.lastname: Park
authors.affiliation: Department of Anesthesiology and Pain Medicine, Chungnam National University Hospital, Daejeon, Korea.
authors.forename: Seong Hyun
authors.initials: SH
authors.lastname: Song
authors.affiliation: Department of Anesthesiology and Pain Medicine, Chungnam National University Hospital, Daejeon, Korea.
authors.forename: Bum June
authors.initials: BJ
authors.lastname: Kim
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000765:Anesthesia, Conduction / Q000401:mortality* / Q000639:trends; D000768:Anesthesia, General / Q000401:mortality* / Q000639:trends; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality* / Q000601:surgery*; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D014521:Urethra / Q000601:surgery*; D001749:Urinary Bladder Neoplasms / Q000401:mortality* / Q000601:surgery*