Evidence map›Paper›PMID 33966891›Full record

Trial reportBritish journal of anaesthesia2021

Comparison between epidural and intravenous analgesia effects on disease-free survival after colorectal cancer surgery: a randomised multicentre controlled trial.

Wiebke Falk, Anders Magnuson, Christina Eintrei, Ragnar Henningsson, Pär Myrelid, Peter Matthiessen, Anil Gupta

Open access · hybridAbstract readComparative StudyMulticenter StudyPragmatic Clinical Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in British journal of anaesthesia, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
32citing papers in PubMed, 3 pooled it
6.7field-weighted citation impact, top 2% 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

32 citing papers in PubMed, 3 syntheses or guidelines pooled it, 53 citations in OpenAlex.

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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

7 authors at 4 institutions in 1 country.

Wiebke FalkDepartment of Anaesthesiology and Intensive Care, School of Medical Sciences, Örebro University, Örebro, Sweden. Electronic address: wiebke.falk@regionorebrolan.se.
Anders MagnusonClinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, Örebro, Sweden.
Christina EintreiDepartment of Anaesthesiology and Intensive Care, Linköping University, Linköping, Sweden.
Ragnar HenningssonDepartment of Anaesthesiology and Intensive Care, Central Hospital Karlstad, Karlstad, Sweden.
Pär MyrelidDepartment of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden; Department of Surgery, Linköping University Hospital, Linköping, Sweden.
Peter MatthiessenDepartment of Surgery, School of Medical Sciences, Örebro University, Örebro, Sweden.
Anil GuptaDepartment of Physiology and Pharmacology, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden.
Örebro University · SELinköping University · SEKarlstad Central Hospital · SEKarolinska University Hospital · SE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThoracic epidural analgesia (TEA) has been suggested to improve survival after curative surgery for colorectal cancer compared with systemic opioid analgesia. The evidence, exclusively based on retrospective studies, is contradictory.

methodsIn this prospective, multicentre study, patients scheduled for elective colorectal cancer surgery between June 2011 and May 2017 were randomised to TEA or patient-controlled i.v. analgesia (PCA) with morphine. The primary endpoint was disease-free survival at 5 yr after surgery. Secondary outcomes were postoperative pain, complications, length of stay (LOS) at the hospital, and first return to intended oncologic therapy (RIOT).

resultsWe enrolled 221 (110 TEA and 111 PCA) patients in the study, and 180 (89 TEA and 91 PCA) were included in the primary outcome. Disease-free survival at 5 yr was 76% in the TEA group and 69% in the PCA group; unadjusted hazard ratio (HR): 1.31 (95% confidence interval [CI]: 0.74-2.32), P=0.35; adjusted HR: 1.19 (95% CI: 0.61-2.31), P=0.61. Patients in the TEA group had significantly better pain relief during the first 24 h, but not thereafter, in open and minimally invasive procedures. There were no differences in postoperative complications, LOS, or RIOT between the groups.

conclusionsThere was no significant difference between the TEA and PCA groups in disease-free survival at 5 yr in patients undergoing surgery for colorectal cancer. Other than a reduction in postoperative pain during the first 24 h after surgery, no other differences were found between TEA compared with i.v. PCA with morphine.

Indexed as

AdultAgedAged, 80 and overAnalgesia, EpiduralAnalgesia, Patient-ControlledAnesthesia, IntravenousColorectal NeoplasmsDisease-Free SurvivalFemaleFollow-Up StudiesHumansMaleMiddle AgedPain MeasurementPostoperative PainProspective Studiescolorectal cancerdisease-free survivalminimally invasive surgeryopen surgerypatient-controlled intravenous analgesiarecurrencethoracic epidural analgesia

Identifiers

PMID33966891
PMCPMC8258969
OpenAlexW3158464606

What OpenQuestion holds

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Registered trials

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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.