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Crosshairs on Cancer: Propofol Versus Inhalational Agents and Cancer Outcomes

Nathan, Naveen MD*

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doi: 10.1213/ANE.0000000000005404
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In this issue of Anesthesia & Analgesia, Chang et al offer a systematic review comparing the effects of propofol-based total intravenous anesthesia (TIVA) with volatile anesthetics on long-term oncological outcomes. Propofol TIVA was associated with better overall survival compared to volatile anesthetics; however, there was no statistically significant difference in recurrence-free survival between groups. In a subgroup analysis, propofol TIVA was associated with better overall survival compared to desflurane but no difference was seen with sevoflurane. The reader is strongly encouraged to explore the salient details of this review to acquire an in-depth interpretation of the findings. Because the effects of anesthetic drugs are but one factor in a complex array of elements that influence cancer progression, further large-scale, randomized controlled trials are needed to further characterize the effects of anesthetic agents and cancer outcomes.


    1. Chang CY, Wu MY, Chien YJ, Su IM, Wang SC, Kao MC. Anesthesia and long-term oncological outcomes: a systematic review and meta-analysis. Anesth Analg. 2021;132:623–634.
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