The influence of anesthesia type on recurrence of the non-muscle invasive bladder tumor according to risk groups: 3 year follow up

Abstract

Purpose: Many risk factors affecting bladder cancer recurrence, such as genetic and environmental factors, have been previously identified. It has been stated that risk factors that cause immunosuppression play a role in the spread of cancer cells. Anesthetic agent, which is a perioperative factor, may affect the risk of cancer recurrence by disrupting the immune system. The aim of this study was to compare the effect of regional anesthesia (RA) and general anesthesia (GA) on non-muscle invasive bladder cancers (NMIBC) recurrence. Materials and methods: A total of one hundred seventy-eight patients who underwent transurethral bladder tumor resection (TURBT) for NMIBC and underwent surgery under GA or RA between 2011 and 2016 in the urology departments of Pamukkale University and Uludağ University were included in the study. In the first group, 80 patients had RA. In the second group, 98 patients underwent GA during TURBT for NMIBC. Results: The recurrence time was shorter in the GA group (5.5 months) than in the RA group (11 months) (p=0.015). First-year relapse was higher in the GA group than in the RA group (p=0.048), but there was no difference in third-year relapse between groups (p=0.810). The mean recurrence time was 11 months (95% CI; 9.058 - 12.942) in the RA group and 5 months (95% CI; 2.090 - 7.910) in the GA group (p=0.031). Conclusion: During transurethral resection of the bladder tumor, an increase in the recurrence time was observed in patients with intermediate-risk NMIBC who received RA compared to patients who received GA. RA provided a 7-month benefit in relapse delay.