Evidence map›Paper›PMID 28364165›Full record

Trial reportJournal of anesthesia2017

Post-mastectomy cancer recurrence with and without a continuous paravertebral block in the immediate postoperative period: a prospective multi-year follow-up pilot study of a randomized, triple-masked, placebo-controlled investigation.

Daphna M Finn, Brian M Ilfeld, Jonathan T Unkart, Sarah J Madison, Preetham J Suresh, Nav Parkash S Sandhu, Nicholas J Kormylo, Nisha Malhotra, Vanessa J Loland, Mark S Wallace and 3 more

Abstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Journal of anesthesia, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed, 2 pooled it
2.2field-weighted citation impact, top 13% 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

11 citing papers in PubMed, 2 syntheses or guidelines pooled it, 34 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Review
  4. Article
  5. Article
  6. Breast Cancer and Anaesthesia: Genetic Influence.International journal of molecular sciences · 2021
    Review
  7. Article
  8. Effects of PropofolFrontiers in oncology · 2021
    Review
  9. Review
  10. Review
  11. Article
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

13 authors at 4 institutions in 1 country.

Daphna M FinnDepartment of Psychiatry, University of California San Diego, 200 West Arbor Drive, San Diego, CA, 92103, USA.ORCID http://orcid.org/0000-0003-2572-7778
Brian M IlfeldDepartment of Anesthesiology, University of California San Diego, 200 West Arbor Drive, San Diego, CA, 92103, USA. bilfeld@ucsd.edu.
Jonathan T UnkartDepartment of Surgery, University of California San Diego, 200 West Arbor Drive, San Diego, CA, 92103, USA.
Sarah J MadisonDepartment of Anesthesiology, University of California San Diego, 200 West Arbor Drive, San Diego, CA, 92103, USA.
Preetham J SureshDepartment of Anesthesiology, University of California San Diego, 200 West Arbor Drive, San Diego, CA, 92103, USA.
Nav Parkash S SandhuDepartment of Anesthesiology, University of California San Diego, 200 West Arbor Drive, San Diego, CA, 92103, USA.
Nicholas J KormyloDepartment of Anesthesiology, University of California San Diego, 200 West Arbor Drive, San Diego, CA, 92103, USA.
Nisha MalhotraDepartment of Anesthesiology, University of California San Diego, 200 West Arbor Drive, San Diego, CA, 92103, USA.
Vanessa J LolandDepartment of Anesthesiology, University of California San Diego, 200 West Arbor Drive, San Diego, CA, 92103, USA.
Mark S WallaceDepartment of Anesthesiology, University of California San Diego, 200 West Arbor Drive, San Diego, CA, 92103, USA.
Cindy H WenDepartment of Ophthalmology, University of California San Diego, 200 West Arbor Drive, San Diego, CA, 92103, USA.
Anya C MorganDepartment of Anesthesiology, University of California San Diego, 200 West Arbor Drive, San Diego, CA, 92103, USA.
Anne M WallaceDepartment of Surgery, University of California San Diego, 200 West Arbor Drive, San Diego, CA, 92103, USA.
University of California San Diego · USMemorial Hospital of South Bend · USOutcomes Research Consortium · USUniversity of Washington · US

Funding

San Diego Clinical and Translational Research InstituteUL1TR000100 · NCATS · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI FIRESTEIN, GARY S · 2012 to 2015
$19.7M
SAN DIEGO CLINICAL AND TRANSLATIONAL RESEARCH INSTITUTEUL1RR031980 · NCRR · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI FIRESTEIN, GARY S · 2010 to 2011
$14.0M
Perineural Anesthetic Infusion After Joint ReplacementK23GM077026 · NIGMS · UNIVERSITY OF FLORIDA · PI ILFELD, BRIAN M · 2005 to 2009
$617k
NCATS NIH HHS UL1 TR000100NCRR NIH HHS UL1 RR031980NIGMS NIH HHS K23 GM077026
6 · The paper itself

Abstract

purposeRetrospective studies have associated perioperative regional anesthesia/analgesia during mastectomy for breast cancer with a decreased incidence of cancer recurrence. However, to date, no prospective data from a randomized controlled trial have been reported. In a previous study we found that extending a single-injection paravertebral block with a multiple-day perineural local anesthetic infusion improves analgesia. This follow-up study investigates the rates of cancer recurrence for the single-injection and multiple-day infusion treatments.

methodsPatients undergoing unilateral (n = 24) or bilateral mastectomy (n = 36) were included in the study. All patients had been diagnosed with breast cancer or tumor in situ, except for six patients who were receiving prophylactic bilateral mastectomy and were excluded from analyses. Patients received unilateral or bilateral single-injection thoracic paravertebral block(s) corresponding to their surgical site(s) with ropivacaine and perineural catheter(s). Subsequently, patients were randomized to receive either ropivacaine 0.4% (n = 30) or normal saline (n = 30) via their catheter(s) until catheter removal on postoperative day 3. Cancer recurrence from the date of surgery until at least 2 years post surgery was investigated via chart review.

resultsFive of the 54 (9.2%) patients experienced a cancer recurrence following mastectomy-3 of 26 (11.5%) of the patients with perineural ropivacaine and 2 of 28 (7.1%) of the patients with perineural saline.

conclusionsThis pilot study found no evidence that extending a single-injection paravertebral block with a multi-day perineural local anesthetic infusion decreases the risk of post-mastectomy cancer recurrence. However, due to the small sample size of this investigation, further research is needed to draw definitive conclusions.

Indexed as

AdultAmidesAnesthetics, LocalBreast NeoplasmsDouble-Blind MethodFemaleFollow-Up StudiesHumansMastectomyMiddle AgedNerve BlockPilot ProjectsPostoperative PainPostoperative PeriodProspective StudiesRopivacaineAmidesAnesthetics, LocalRopivacaineCancer recurrenceContinuous paravertebral blockMastectomy

Identifiers

PMID28364165
PMCPMC5476449
OpenAlexW2601874815

What OpenQuestion holds

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Registered trials

None linked

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.