• Jun Fang, Shu-Nv Cai, Hui-Fang Jiang, Hui-Dan Zhou, and Yan-Hong Lian.
• Department of Anesthesiology, Zhejiang Cancer Hospital, Hangzhou 310022, China. fangjunok@126.com
• Zhonghua Yi Xue Za Zhi. 2009 Sep 8;89(33):2319-23.

ObjectiveTo investigate whether preoperative chemotherapy history could influence the incidence of early postoperative cognitive dysfunction (POCD) in elderly tumor patients.MethodsA total of 107 tumor patients (> or = 60 years old, tumor TNM stages T2 - T3, N0 - N3, ASA I -III class) undergoing elective radical surgery of gastric or colorectal cancer were selected and assigned into two groups according to preoperative chemotherapy history: with preoperative chemotherapy history group (C group, n = 52) and without preoperative chemotherapy history group (N group, n = 55). Patients in two groups received radical surgery under intravenous-inhalation general anesthesia combined with epidural anesthesia. Cognitive function was assessed using a battery of neuropsychological tests from five aspects including memory, verbal intelligence, visual-motor, executive function and motor function at 1 day preoperatively and 3 days postoperatively.ResultsThere was no significant difference in general state of patient preoperatively health including sex ratio, body mass index, complications, cancer types and stages, ASA classification between two groups (P > 0.05). Neither significant difference was found in duration of anesthesia and surgery, intra-operative bleeding volume and transfusion volume between two groups (P > 0.05). There was no significant difference in ICU admission rate, ICU stay, incidence of complications, hospitalization duration and mortality rate between two groups (P > 0.05). Preoperative neuropsychological test score in group C was slightly lower than that in group N, but the difference was not significant (P > 0.05). Impaired incidence rate of digit-symbol substitution test, controlled oral word association test, grooved pegboard non-dominant hand test and semantic fluency test at 3 days postoperation in group C were significantly higher than those in N group (P < 0.05). Incidence of POCD at 3 days postoperation in group C was significantly higher than that in group N (42.3% vs 15.4% , P < 0.05).ConclusionChemotherapy preoperatively could increase the incidence of early postoperative cognitive dysfunction in elderly with tumor.

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