• Eriko Takeyama, Masaaki Miyo, Hisanori Matsumoto, Kenji Tatsumi, Eizo Amano, Motohiro Hirao, and Hiromi Shibuya.
• Department of Anesthesiology, National Hospital Organization Osaka National Hospital, 2-1-14, Hoenzaka, Chuo-Ku, Osaka-city, Osaka, 540-0006, Japan.
• J Anesth. 2021 Aug 1; 35 (4): 495-504.

BackgroundThis study aimed to evaluate the influence of anesthetic management with propofol or sevoflurane on the prognosis of patients undergoing gynecologic cancer surgery.MethodsThis retrospective cohort study included patients who underwent gynecologic cancer (cervical, endometrial, and ovarian cancer) surgery between 2006 and 2018 at the National Hospital Organization Osaka National Hospital. Patients were grouped according to anesthesia type for maintenance of anesthesia: propofol or sevoflurane. After propensity score matching, Kaplan-Meier survival curves were constructed for overall survival, cancer-specific survival, and recurrence-free survival. Univariate and multivariate cox regression models were used to compare hazard ratios for recurrence-free survival.ResultsA total of 193 patients with propofol and 94 with sevoflurane anesthesia were eligible for analysis. After propensity score matching, 94 patients remained in each group. The sevoflurane group showed significantly lower survival rates than the propofol group with respect to 10-year overall survival (89.3% vs. 71.6%; p = 0.007), 10-year cancer-specific survival (91.0% vs 80.2%; p = 0.039), and 10-year recurrence-free survival (85.6% vs. 67.7%; p = 0.008). Sevoflurane anesthesia was identified as an independent risk factor for recurrence-free survival. Furthermore, distant recurrence was significantly more frequent in the sevoflurane group than in the propofol group (p < 0.001).ConclusionIn patients undergoing gynecologic cancer surgery, sevoflurane anesthesia was associated with worse overall, cancer-specific, and recurrence-free survival than propofol anesthesia.© 2021. Japanese Society of Anesthesiologists.

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