Does Anesthesia Choice Impact Colon Cancer Survival?

patient undergoing anesthesia
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The type of general anesthesia patients choose during colon cancer surgery may impact their chances of survival years down the road, according to research findings presented at the 2007 American Society of Clinical Oncology Annual Meeting. Their findings and conclusion went counter to those for other types of cancer. Further review of other studies reached a different conclusion, which points out the weakness of basing your surgical options on one study.

The theory is that stress on the immune system and its ability to clean up cancer cells released during surgery could be the source of the differences between anesthetic techniques. If epidural anesthesia is used in addition to general anesthesia, the patient will need less opioid medication for pain relief. Opioids can suppress the immune response, which may allow more cancer cells to survive and possibly lead to recurrence.

About the Anesthesia Research

Researchers looked at data from 177 colon cancer patients who had participated in a study where some patients received unsupplemented general anesthesia (UGA) and others received epidural-supplemented general anesthesia (ESGA) during colon cancer surgery. The researchers didn't actually conduct a study with their own participants; they performed analysis and calculations based on data from another study.

Results of the Anesthesia Research

A clear pattern emerged that led the researchers to conclude that UGA is a better option than ESGA for colon cancer surgery.

Basically, their number-crunching determined that patients who had received ESGA tended to fare worse in the long term (after about five years) than patients who'd opted for UGA. They think it might be due to a number of factors, including reduced blood flow to the organs during ESGA.

Limitations of this Research

There are a lot of limitations here.

First, there isn't much research about this topic. Whenever that is the case, it's generally wise to reserve judgment until more studies have been conducted. Second, the analysis was done on limited data. Relevant information was only available for 177 people, which is a pretty small number.

Further Studies of Anesthetic Technique and Survival in Colon Cancer Do Not Reach Same Conclusion

A review of studies published in 2015 found that epidural anethesia was associated with a better survival rate in four of seven studies, the opposite of what the 2007 study found. Rectal cancer patients were more likely to benefit from use of epidurals. Overall, the review concluded that "the association between epidural anethesia and survival of colon and rectal cancer is not clear." They noted that none of the studies they included showed a negative influence of epidurals on survival.

What does this mean for a patient facing surgery? Discuss anesthesia choices with your medical team to find out why they recommend one or another for your case.

More Research About Colon Cancer Surgery

Source: Christopherson, R. and James, K. "Long-Term Survival Following Colon Cancer Surgery: Variation Associated with Choice of Anesthesia." Journal of Clinical Oncology 2007 ASCO Annual Meeting Proceedings (Post-Meeting Edition) 25.18S (20 Jun. 2007): 17015. Accessed 22 Jun. 2007 [http://meeting.jco.org/cgi/content/abstract/25/18_suppl/17015?ct=ct].

F. Jeroen Vogelaar, Daan J. Lips, Frank R.C. van Dorsten, Valery E. Lemmens and Koop Bosscha. "Impact of anaesthetic technique on survival in colon cancer: a review of the literature." Gastroenterology Report (2015) doi: 10.1093/gastro/gov001 First published online: February 16, 2015

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