Intraoperative use of dexmedetomidine is associated with decreased overall survival after lung cancer surgery.
Intraoperative use of dexmedetomidine is associated with decreased overall survival after lung cancer surgery.
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DOI：
10.4103/joacp.joacp_299_16
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发表时间：
2017-07
期刊：
影响因子：
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通讯作者：
Ben-Eliyahu S
中科院分区：
文献类型：
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作者：
Cata JP;Singh V;Lee BM;Villarreal J;Mehran JR;Yu J;Gottumukkala V;Lavon H;Ben-Eliyahu S
目的是评估术中使用右美托咪定与非小细胞肺癌（NSCLC）手术后无复发生存期（RFS）和总生存期（OS）增加之间的关系。这是一项倾向评分匹配（PSM）回顾性研究。单一学术中心。该研究包括I期至IIIa期非小细胞肺癌患者。年龄小于18岁的患者被排除在外。研究的主要结果是RFS和OS。采用PSM后单因素和多因素Cox比例风险模型（n = 251/组）评估RFS和OS，以评估术中右美托咪定使用与主要结局之间的关系。P < 0.05为差异有统计学意义。在PSM和调整显著协变量后，多变量分析显示右美托咪定的使用与RFS之间没有关联(风险比[HR][95%可信区间（CI）]: HR = 1.18, 95% CI: 0.91-1.53；P = 0.199)。多变量分析还显示右美托咪定用药与降低OS之间存在关联（HR = 1.28, 95% CI: 1.03-1.59; P = 0.024）。本研究表明，术中使用右美托咪定对NSCLC患者的RFS没有显著影响，但会恶化OS。需要进行随机对照研究来证实本研究的结果。
The aim is to evaluate the association between the use of intraoperative dexmedetomidine with an increase in recurrence-free survival (RFS) and overall survival (OS) after nonsmall cell lung cancer (NSCLC) surgery. This was a propensity score-matched (PSM) retrospective study. Single academic center. The study comprised patients with Stage I through IIIa NSCLC. Patients were excluded if they were younger than 18 years. Primary outcomes of the study were RFS and OS. RFS and OS were evaluated using univariate and multivariate Cox proportional hazards models after PSM (n = 251/group) to assess the association between intraoperative dexmedetomidine use and the primary outcomes. The value of P < 0.05 was considered statistically significant. After PSM and adjusting for significant covariates, the multivariate analysis demonstrated no association between the use of dexmedetomidine and RFS (hazard ratio [HR] [95% confidence interval (CI)]: HR = 1.18, 95% CI: 0.91–1.53; P = 0.199). The multivariate analysis also demonstrated an association between the administration of dexmedetomidine and reduced OS (HR = 1.28, 95% CI: 1.03–1.59; P = 0.024). This study demonstrated that the intraoperative use of dexmedetomidine to NSCLC patients was not associated with a significant impact on RFS and but worsening OS. A randomized controlled study should be conducted to confirm the results of this study.