Association between preoperative glucocorticoids and long-term survival and cancer recurrence after colectomy: follow-up analysis of a previous randomized …
PP Singh, DP Lemanu, MHG Taylor… - British Journal of …, 2014 - academic.oup.com
PP Singh, DP Lemanu, MHG Taylor, AG Hill
British Journal of Anaesthesia, 2014•academic.oup.comBackground The effect of anaesthetic drugs on long-term oncological outcomes after cancer
surgery is an area of current interest. Dexamethasone is widely used in anaesthetic practice;
however, its effect on long-term survival and cancer outcomes is not known. This study
presents the results of a 5-yr follow-up of patients receiving dexamethasone before elective
colectomy as part of a previous randomized clinical trial. Methods Sixty patients who
underwent elective open colonic resection for any indication between June 2006 and March …
surgery is an area of current interest. Dexamethasone is widely used in anaesthetic practice;
however, its effect on long-term survival and cancer outcomes is not known. This study
presents the results of a 5-yr follow-up of patients receiving dexamethasone before elective
colectomy as part of a previous randomized clinical trial. Methods Sixty patients who
underwent elective open colonic resection for any indication between June 2006 and March …
Background
The effect of anaesthetic drugs on long-term oncological outcomes after cancer surgery is an area of current interest. Dexamethasone is widely used in anaesthetic practice; however, its effect on long-term survival and cancer outcomes is not known. This study presents the results of a 5-yr follow-up of patients receiving dexamethasone before elective colectomy as part of a previous randomized clinical trial.
Methods
Sixty patients who underwent elective open colonic resection for any indication between June 2006 and March 2008 were randomized to receive either 8 mg i.v. dexamethasone or placebo before surgery. A 5-yr follow-up analysis was conducted to evaluate overall survival, disease-free survival and recurrence specifically for patients undergoing resection for Stage I–III colon cancer. Kaplan–Meier analysis was performed and log-rank test was used to evaluate difference in survival between groups.
Results
Forty-three of the 60 subjects had Stage I–III colon cancer and were included in the follow-up analysis. Twenty received preoperative dexamethasone and 23 received placebo. There were no significant differences between groups in baseline or disease characteristics. No differences were found between groups for overall or disease-free survival. In the dexamethasone group, there was a significantly higher rate of distant recurrence (6 compared with 1, P=0.04).
Conclusions
Preoperative dexamethasone was associated with a higher rate of distant recurrence in patients undergoing colectomy for colon cancer. Given the small sample size, this finding should be interpreted with caution, but warrants further investigation in a prospective study.
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