The Relationship Between Anesthesia Methods And Prognosis Of Patients With Non-muscular Invasive Bladder Cancer

Objective: To investigate the relationship between different anesthesia methods and prognosis of non-muscle invasive bladder cancer(NMIBC).Methods:We retrospectively analyzed the clinical data of 491 patients with NMIBC treated by transurethral resection of bladder tumor.According to the different methods of intraoperative anesthesia,189 cases were divided into intravenous anesthesia group,120 cases in intravenous inhalation combined anesthesia group and 182 cases in local anesthesia group(spinal or epidural anesthesia).The recurrence-free survival curves were made with Kaplan-Meier method,and compared with log-rank test.Cox multivariate analysis was used to analyze the independent risk factors of prognosis of non-muscle invasive bladder cancer.Results:The difference in recurrence-free survival rates among the three groups was statistically significant(P<0.05).The recurrence free survival rate of the intravenous anesthesia group and the local anesthesia group was higher than that of the intravenous inhalation combined anesthesia group(P<0.05),while the recurrence free survival rate of the local anesthesia group and the intravenous anesthesia group was not statistically significant(P>0.05).Univariate analysis showed that anesthesia,previous history of bladder cancer,pathological grade,number of tumors,and size of tumors were associated with recurrence-free survival(P<0.05).Multivariate analysis showed that anesthesia,previous history of bladder cancer,pathological grade,tumor size,and number of tumors were independent risk factors for recurrence of bladder cancer(P<0.05).The risk of tumor recurrence in patients with combined intravenous and inhalation anesthesia was higher than that in patients with intravenous and local anesthesia(P<0.05).Conclusion:Intraoperative anesthesia is an independent risk factor for recurrence-free survival ofNMIBC patients.Compared with local anesthesia and intravenous anesthesia,intravenous anesthesia may increase the risk of recurrence in patients with NMIBC after TURBT.