Relationship between anesthesia methods and prognosis of patients with non-muscle-invasive bladder cancer

Abstract Objective To investigate the relationship between different anesthesia methods and the prognosis of patients with non-muscle-invasive bladder cancer (NMIBC). Methods We retrospectively analyzed the clinical, pathological, and follow-up data of 491 patients diagnosed with NMIBC by transurethral resection of bladder tumor (TURBT) from January 2010 to December 2018 in our hospital. Patients were divided into groups according to the different methods of intraoperative anesthesia: intravenous, combined intravenous-inhalation, and local (spinal or epidural anesthesia) anesthesia groups. The recurrence-free survival was evaluated using Kaplan-Meier’s method and compared among the groups using the log-rank test. Cox multivariate analysis was used to identify the independent risk factors affecting the prognosis of patients with NIMBC. Results Of the 532 patients included in the study, 491 were followed up, with a follow-up rate of 92.3%. The average follow-up time was 33.5 months. There were 189 (38.5%) patients in the intravenous anesthesia group, 120 (24.4%) in the combined intravenous-inhalation anesthesia group, and 182 (37.1%) in the local anesthesia group. There was no significant difference in the clinical data among the three groups (P > 0.05). In the univariate analysis, anesthesia, previous history of bladder cancer, pathological grade, and tumor number and size were associated with the recurrence-free survival (P < 0.05). The multivariate analysis showed that anesthesia, previous history of bladder cancer, pathological grade, and tumor size and number were independent risk factors for bladder cancer recurrence (P < 0.05). Conclusion Intraoperative anesthesia is an independent risk factor affecting the recurrence-free survival of patients with NMIBC. Compared with local and intravenous anesthesia, combined intravenous inhalation anesthesia may increase the risk of recurrence in patients with NMIBC after TURBT.