Evidence map›Paper›PMID 35182173›Full record

SynthesisInternational journal of colorectal disease2022

Effect of combined epidural-general anesthesia on long-term survival of patients with colorectal cancer: a meta-analysis of cohort studies.

Shaoqiong Zhang, Tianqi Gao, Yuanyuan Li, Kaile Cui, Bo Fang

Abstract readMeta-AnalysisReview
PubMed Publisher
In one paragraph

Synthesis in International journal of colorectal disease, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
2.4field-weighted citation impact, top 11% 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

7 citing papers in PubMed, 1 synthesis or guideline pooled it, 15 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Review
  4. Article
  5. Article
  6. Review
  7. 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

5 authors at 2 institutions in 1 country.

Shaoqiong ZhangDepartment of Anesthesiology, The First Affiliated Hospital of China Medical University, Shenyang, China.ORCID http://orcid.org/0000-0003-4925-8603
Tianqi GaoDepartment of Oncology, The Second Hospital of Dalian Medical University, Dalian, China.ORCID http://orcid.org/0000-0001-8751-6429
Yuanyuan LiDepartment of Anesthesiology, The First Affiliated Hospital of China Medical University, Shenyang, China.ORCID http://orcid.org/0000-0002-0899-5693
Kaile CuiDepartment of Anesthesiology, The First Affiliated Hospital of China Medical University, Shenyang, China.ORCID http://orcid.org/0000-0002-6653-0288
Bo FangDepartment of Anesthesiology, The First Affiliated Hospital of China Medical University, Shenyang, China. bfang@cmu.edu.cn.ORCID http://orcid.org/0000-0002-4812-6919
First Hospital of China Medical University · CNDalian Medical University · CN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThis study aimed to analyze the long-term survival of patients with colorectal cancer after receiving combined epidural-general anesthesia (EGA) or general anesthesia (GA) alone.

methodsThe PubMed, MEDLINE, Web of Science, Cochrane Library, and Embase databases were used to search for cohort studies that explored the differences between the effects of EGA and GA on overall survival (OS) and recurrence-free survival (RFS) of patients with colorectal cancer. The hazard ratios (HRs) and their 95% confidence intervals (95%CIs) were used as indicators to evaluate the strength of the effects and were pooled.

resultsNine studies were included in the meta-analysis. EGA improved the OS of patients with colorectal cancer compared with GA (HR = 0.904, 95%CI 0.871-0.938, P < 0.05). In the subgroup analysis, EGA was more protective for OS of patients with colon cancer than GA (HR = 0.840, 95%CI 0.732-0.963, P < 0.05), but not for OS of patients with rectal cancer (HR = 0.764, 95%CI 0.398-1.469, P > 0.05). Additionally, EGA could not further prolong RFS in patients with colorectal cancer (HR = 1.015, 95%CI 0.942-1.093, P > 0.05), which was the same in the subgroup analysis of patients with colon cancer (HR = 0.908, 95%CI 0.760-1.085, P > 0.05).

conclusionEGA could improve the OS of patients with colorectal cancer, especially those with colon cancer, but it could not improve the OS in the subgroup of patients with rectal cancer. This difference may be due to the immune protective function of the parasympathetic nerve innervating the intestinal tubes above the splenic flexure retained by EGA. Additionally, although EGA has a protective effect on RFS in patients with colorectal cancer, the difference was not significant.  The design of this analysis is registered and displayed in the PROSPERO database (CRD42021274864).

Indexed as

Anesthesia, GeneralColorectal NeoplasmsCohort StudiesHumansProportional Hazards ModelsAutonomic nervesColorectal cancerEpidural anesthesiaOverall survivalRecurrence-free survival

Identifiers

PMID35182173
OpenAlexW4213079170

What OpenQuestion holds

Textmetadata
Read underepoch 390

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.