Type of Anesthesia May Affect Recurrence Risk after Liver Cancer Procedure

For patients undergoing a minimally invasive treatment for liver cancer, the risk of recurrent cancer appears lower with general anesthesia compared to regional (epidural) anesthesia, reports a study in the February issue of Anesthesia & Analgesia, official journal of the International Anesthesia Research Society (IARS).

That's in contrast to studies of other types of cancer, which have found lower recurrence rates when cancer surgery is performed using regional anesthesia. "The benefit of regional anesthesia on cancer recurrence, to the extent that it exists, may depend on the specific tumor type," according to the new study, led by Dr Renchun Lai of Sun Yat-Sen University Cancer Center, Guangzhou, China.

General Anesthesia May Lower Recurrence Rate for HCC…
The researchers evaluated the effects of type of anesthesia on recurrence risk in patients with hepatocellular carcinoma (HCC), the most common type of liver cancer. The patients underwent a nonsurgical procedure called percutaneous radiofrequency ablation (RFA), in which a small probe is placed into the liver to destroy cancers using radiofrequency waves.

Dr Lai and colleagues examined the outcomes of 179 patients who underwent RFA for small HCCs between 1999 and 2008. The procedure was done using general anesthesia in 117 patients and epidural anesthesia in 62. Most familiar from its use during labor and delivery, epidural anesthesia is a type of regional anesthesia that numbs the lower body, but doesn't put the patient to sleep.

The researchers compared the risk of HCC recurrence among patients receiving general versus epidural anesthesia. In previous studies of surgery for several types of cancer - including colon, breast, and prostate cancer - recurrence rates have been lower with regional anesthesia.

However, in patients undergoing RFA for HCC, the opposite was true: the recurrence rate was lower with general anesthesia. With adjustment for other variables, including risk factors for recurrence, the risk of recurrent HCC was about four times higher for patients receiving epidural anesthesia.

Liver cancer, or hepatocellular carcinoma, is a disease in which malignant cells grow in the tissue of the liver, one of the largest organs in the body.

The liver is an essential organ that people cannot live without. It processes and stores many of the nutrients absorbed from the intestine, causes the secretion of bile that helps in the digestion of food, and produces some of the clotting factors that keep you from bleeding too much when cut or injured. The liver gets most of its supply of blood from the hepatic portal vein, which carries nutrient-rich blood from the intestines; the rest comes from the hepatic artery, which supplies the liver with blood that is rich in oxygen.

Because the liver is made up of several different types of cells, several types of tumors can form in the liver; some are cancerous and some are benign.