Moderated Poster Session I: Oncology Thursday, September 29, 2016 10:15 am – 12:00 pm

摘要

Background: Thoracic epidural analgesia (TEA) is commonly used to manage postoperative pain and facilitate early mobilization after major intra-abdominal surgery. Evidence also suggests that regional anesthesia/analgesia may be associated with improved survival after cancer surgery. Here, we describe factors associated with TEA at the time of radical cystectomy (RC) for bladder cancer and its association with both short- and long-term outcomes in routine clinical practice. Methods: All patients undergoing RC in the province of Ontario between 2004 and 2008 were identified using the Ontario Cancer Registry (OCR). Modified Poisson regression was used to describe factors associated with epidural use, while a Cox proportional hazards model describes associations between survival and TEA use. Results: Over the five-year study period, 1628 patients were identified as receiving a RC, 54% (n=887) of whom received TEA. Greater anesthesiologist volume (lowest volume providers RR=0.85, 95% CI 0.75–0.96) and male sex (female sex RR 0.89, 95% CI 0.79–0.99) were independently associated with greater use of TEA. Improved short-term outcomes were not associated with TEA use. In multivariate analysis, TEA was not associated with cancer-specific survival (HR 1.02 [95% CI 0.87–1.19]; p=0.804) or overall survival (HR 0.91 [95% CI 0.80–1.03; p=0.136]). Conclusions: In routine clinical practice, 54% of RC patients received TEA in routine and its use was associated with anesthesiologist provider volume. After controlling for patient, disease, and provider variables, we were unable to demonstrate any effect on either short- or long-term outcomes at the time of RC. Can Urol Assoc J. 2016 Sep-Oct; 10(9-10Suppl4): S158–S200. ? P2: A Canadian prostate cancer electronic library for improved function post-treatment (eLIFT) Can Urol Assoc J. 2016 Sep-Oct; 10 (9-10Suppl4) : S158. Published online 2016 Sep 5. P2: A Canadian prostate cancer electronic library for improved function post-treatment (eLIFT) Joseph Chin ,1 Garson Chan ,1 Jennifer Goulart ,2 Khurram Siddiqui ,1 Elizabeth Wambolt ,1 Hon Leong ,1 Sally Hodgson ,2 Nelson Leong ,2 and Kristin Tangen-Steffins 2 1Western University, London, ON, Canada; 2BC Cancer Agency, Victoria, BC, Canada Author information ? Copyright and License information ? Copyright : ? 2016 Canadian Urological Association or its licensors