Evidence map›Paper›PMID 23437162›Full record

SynthesisPloS one2013

The effect of anesthetic technique on survival in human cancers: a meta-analysis of retrospective and prospective studies.

Wan-Kun Chen, Chang-Hong Miao

3 registry-linked trialsOpen access · goldAbstract readMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in PloS one, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 3 registered trials, which are not on this map. Cited by 50 papers, 7 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
50citing papers in PubMed, 7 pooled it
9.8field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT01978717 nacompletednot on this map

General Anesthesia Combined With Epidural Anesthesia Mitigates the Surgical Stress-related Immunosuppression in Patients With Colorectal Cancer

TypeinterventionalSponsorChanghong MiaoRan2011 to 2012Enrolled53ConditionsColorectal NeoplasmsArmsepidural anesthesia, general anesthesia
NCT03012945 nacompletednot on this mapstarted 2014, after this paper: background citation

Impact of Epidural Anesthesia-analgesia on Long-term Outcome in Elderly Patients After Surgery: 5-year Follow-up of a Multicenter Randomized Controlled Trial

TypeinterventionalSponsorPeking University First HospitalRan2014 to 2019Enrolled1,802ConditionsElderly, Malignant Tumor, Surgical Resection, Epidural AnesthesiaArmsCombined epidural-general anesthesia, General anesthesia
NCT03335826 nacompletednot on this mapstarted 2017, after this paper: background citation

Impact of Epidural Anesthesia-analgesia on Long-term Outcomes in Elderly Patients After Surgery: 5-year Follow-up of a Multicenter Randomized Controlled Trial

TypeinterventionalSponsorPeking University First HospitalRan2017 to 2019Enrolled1,802ConditionsElderly Patients, Solid Organ Cancer, Surgical Resection, Epidural AnesthesiaArmsCombined epidural-general anesthesia, General anesthesia
3 · Its place in the literature

Who cites it

50 citing papers in PubMed, 7 syntheses or guidelines pooled it, 141 citations in OpenAlex.

  1. Pooled it
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  6. Anaesthetic techniques for risk of malignant tumour recurrence.The Cochrane database of systematic reviews · 2014
    Pooled it
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  10. Treatment with methylnaltrexone is associated with increased survival in patients with advanced cancer.Annals of oncology : official journal of the European Society for Medical Oncology · 2016
    Trial
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  12. General and Regional Anaesthesia in Cancer Surgery: A 20-year Bibliometric Analysis.Turkish journal of anaesthesiology and reanimation · 2026
    Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

2 authors at 1 institution in 1 country.

Wan-Kun ChenDepartment of Anesthesiology, Shanghai Cancer Center and Cancer Institute, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China. wkchen1981@hotmail.com
Chang-Hong Miao
Fudan University Shanghai Cancer Center · CN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Animal models have shown that regional anesthesia (combined with or without general anesthesia) would attenuate the surgical stress response by preserving immune function and result in better long-term outcome. In order to test the hypothesis that cancer patients who had surgery with epidural anesthesia (EA) would have better outcome (either overall survival [OS] or recurrence-free survival [RFS]) than those who were general anesthesia (GA), we performed this meta-analysis. By searching relevant literature, a total of 14 studies containing 18 sub-studies (seven in OS analysis and eleven in RFS analysis) were identified and meta-analyzed. Adjusted hazard ratios (HRs) with 95% confidence intervals (CIs) were used to assess the strength of association. For OS, the random-effects model was used to analyze the data and demonstrated an OS benefit in favor of EA compared with GA alone (HR = 0.84, 95% CI 0.74-0.96, P = 0.013). The influence analysis showed the robustness of the results. Specifically, a significantly positive association between EA and improved OS was observed in colorectal cancer (HR = 0.65, 95% CI 0.43-0.99, P = 0.045). For RFS, the random-effects model was used to analyze the data and no significant relationship between RFS benefit and EA (HR = 0.88, 95% CI 0.64-1.22, P = 0.457) was detected. In conclusion, our meta-analysis suggests that epidural anesthesia and/or analgesia might be associated with improved overall survival in patients with operable cancer undergoing surgery (especially in colorectal cancer), but it does not support an association between epidural anesthesia and cancer control. Prospective studies are needed to determine whether the association between epidural use and survival is causative.

Indexed as

Anesthesia, EpiduralAnesthesia, GeneralColorectal NeoplasmsDisease-Free SurvivalHumansProspective StudiesRetrospective StudiesSurvival AnalysisTreatment Outcome

Identifiers

PMID23437162
PMCPMC3577858
OpenAlexW1994525571

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.