Anesthesia & Analgesia

Skip Navigation LinksHome > October 2011 - Volume 113 - Issue 4 > Malignant Disease Within 5 Years After Surgery in Relation t...
Anesthesia & Analgesia:
doi: 10.1213/ANE.0b013e31821f950e
Patient Safety: Research Reports

Malignant Disease Within 5 Years After Surgery in Relation to Duration of Sevoflurane Anesthesia and Time with Bispectral Index Under 45

Lindholm, Maj-Lis PhD; Granath, Fredrik PhD; Eriksson, Lars I. MD, PhD; Sandin, Rolf MD, PhD

Supplemental Author Material
Collapse Box


BACKGROUND: Surgery, general anesthesia, and related events have been implicated to promote cancer proliferation. We investigated the incidence of cancer within 5 years after surgery in relation to duration of anesthesia (TANESTH) and also by time with bispectral index (BIS) under 45 (TBIS<45) serving as a proxy for more profound anesthesia exposure.

METHODS: New malignant diagnoses after surgery under sevoflurane anesthesia were obtained in a prospective cohort of 2972 BIS-monitored patients without any clinically diagnosed malignant disease at the time of index surgery. The risk of cancer during follow-up in relation to TANESTH and TBIS<45 was assessed by Cox regression. The cancer incidence in this surgical population was compared with the incidence in a standardized general population by calculation of standard incidence ratio.

RESULTS: One hundred twenty-nine patients (4.3%) were assigned 136 new malignant diagnoses within 5 years after surgery. No relation between TANESTH or TBIS<45 and new malignant disease was found, nor were any significant relations obtained when other thresholds for BIS (i.e., <30, <40, and <50, respectively) were used in the calculations. The standard incidence ratio for new malignant disease was 1.37 (confidence interval, 1.15–1.62).

CONCLUSION: Neither duration of anesthesia nor increased cumulative time with profound sevoflurane anesthesia was associated with an increased risk for new malignant disease within 5 years after surgery in previously cancer-free patients.

© 2011 International Anesthesia Research Society

You currently do not have access to this article.

You may need to:

Note: If your society membership provides for full-access to this article, you may need to login on your society’s web site first.


Become a Society Member

Article Tools


Article Level Metrics