Regional anesthesia/analgesia and the risk of cancer recurrence and mortality after prostatectomy: a meta-analysis

Aims: To determine whether the use neuraxial anesthesia/analgesia is associated with longer biochemical recurrence-free survival (BRFS) and overall survival (OS) after radical prostatectomy. Methods: Ten studies were included in the meta-analysis. A random-effects model was used to estimate the hazard ratios (HRs). Results: The HR for BRFS was 1.02 (95% CI: 0.91-1.15) for all studies and 1.08 (95% CI: 0.91-1.15) for those that included propensity score matching. For OS, the HR across all studies was 0.91 (95% CI: 0.7-1.15) and 0.81 (95% CI: 0.68-0.96; p = 0.016) for those reporting propensity score matching. Conclusion: The anesthetic technique used during oncologic prostatectomy surgery is not associated with longer BRFS. By contrast, the use of regional analgesia appears to improve OS.