Intra-arterial lidocaine improves long-term survival in patients with hepatocellular carcinoma undergoing transcatheter arterial chemoembolisation: a retrospective propensity score-matched study

IF 9.2 1区医学 Q1 ANESTHESIOLOGY British journal of anaesthesia Pub Date : 2025-03-20 DOI:10.1016/j.bja.2025.01.042

Fang Yan , Wanyu Wang , Zhiwen Yang , Yang Huang , Yan Rao , Ge Qu , Hui Peng , Ming Shi , Weian Zeng , Dongtai Chen , Wei Xing

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Abstract

Background

Lidocaine, the most widely used local anaesthetic, has anticancer effects in both laboratory findings and retrospective clinical studies. We explored the potential benefits of intra-arterial lidocaine on long-term survival in patients with hepatocellular carcinoma (HCC) undergoing transcatheter arterial chemoembolisation (TACE).

Methods

This retrospective cohort study included patients with HCC who received TACE as initial treatment from August 2011 to October 2016. Eligible patients were categorised into no lidocaine and lidocaine groups. Propensity score matching was undertaken. Progression-free survival (PFS) and overall survival were compared between the two groups. Subgroup analysis was performed to explore the survival benefit of combining intra-arterial lidocaine with platinum-based chemotherapy during TACE.

Results

Of 374 eligible patients, 96 were in the lidocaine group and 278 were in the no lidocaine group. Survival analysis showed that intra-arterial lidocaine was associated with longer PFS (P=0.004) and overall survival (P<0.001). After propensity score matching, PFS (P<0.001) and overall survival (P=0.001) benefits of lidocaine remained. Multivariate analysis showed that intra-arterial lidocaine was an independent prognostic factor for PFS (P=0.011) and overall survival (P=0.044). The impact of intra-arterial lidocaine was similar in patients receiving the TACE regimen with platinum (PFS: P=0.014; overall survival: P=0.023).

Conclusions

Intra-arterial lidocaine might improve long-term survival in patients with HCC undergoing TACE and in the subgroup of patients receiving platinum. The study highlights the potential antitumour benefits of combining lidocaine and chemotherapeutics in patients with cancer.

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动脉内利多卡因改善肝细胞癌经导管动脉化疗栓塞患者的长期生存率：一项回顾性倾向评分匹配研究

背景：利多卡因是应用最广泛的局部麻醉剂，在实验室发现和回顾性临床研究中都有抗癌作用。我们探讨了动脉内利多卡因对肝细胞癌（HCC）经导管动脉化疗栓塞（TACE）患者长期生存的潜在益处。方法：本回顾性队列研究纳入2011年8月至2016年10月接受TACE作为初始治疗的HCC患者。符合条件的患者分为无利多卡因组和利多卡因组。进行倾向评分匹配。比较两组患者的无进展生存期（PFS）和总生存期。通过亚组分析，探讨动脉内利多卡因联合铂基化疗在TACE期间的生存获益。结果：374例符合条件的患者中，利多卡因组96例，未使用利多卡因组278例。生存分析显示，动脉内注射利多卡因与更长的PFS （P=0.004）和总生存期(P)相关。结论：动脉内注射利多卡因可能改善肝细胞癌TACE患者和接受铂治疗亚组患者的长期生存。该研究强调了利多卡因联合化疗对癌症患者的潜在抗肿瘤益处。

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来源期刊

British journal of anaesthesia 医学-麻醉学

CiteScore

13.50

自引率

7.10%

发文量

488

审稿时长

27 days

期刊介绍： The British Journal of Anaesthesia (BJA) is a prestigious publication that covers a wide range of topics in anaesthesia, critical care medicine, pain medicine, and perioperative medicine. It aims to disseminate high-impact original research, spanning fundamental, translational, and clinical sciences, as well as clinical practice, technology, education, and training. Additionally, the journal features review articles, notable case reports, correspondence, and special articles that appeal to a broader audience. The BJA is proudly associated with The Royal College of Anaesthetists, The College of Anaesthesiologists of Ireland, and The Hong Kong College of Anaesthesiologists. This partnership provides members of these esteemed institutions with access to not only the BJA but also its sister publication, BJA Education. It is essential to note that both journals maintain their editorial independence. Overall, the BJA offers a diverse and comprehensive platform for anaesthetists, critical care physicians, pain specialists, and perioperative medicine practitioners to contribute and stay updated with the latest advancements in their respective fields.