Intraoperative use of dexmedetomidine is associated with decreased overall survival after lung cancer surgery

Juan P Cata; Vinny Singh; Brenda M Lee; John Villarreal; John R Mehran; J Yu; Vijaya Gottumukkala; Hagar Lavon; Shamgar Ben-Eliyahu

doi:10.4103/joacp.JOACP_299_16

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ORIGINAL ARTICLE

Year : 2017 | Volume : 33 | Issue : 3 | Page : 317-323

Intraoperative use of dexmedetomidine is associated with decreased overall survival after lung cancer surgery

Juan P Cata¹, Vinny Singh², Brenda M Lee³, John Villarreal⁴, John R Mehran⁵, J Yu⁶, Vijaya Gottumukkala⁴, Hagar Lavon⁷, Shamgar Ben-Eliyahu⁷
¹ Department of Anesthesiology and Perioperative Medicine, The University of Texas – MD Anderson Cancer Center; Department of Anesthesia and Surgical Oncology Research Group, Texas, USA
² Department of Internal Medicine, Nassau University Medical Center, NY, USA
³ Department of Anesthesiology and Perioperative Medicine, Tufts Medical Center, Boston, MA, USA
⁴ Department of Anesthesiology and Perioperative Medicine, The University of Texas – MD Anderson Cancer Center, Texas, USA
⁵ Department of Thoracic Surgery, The University of Texas – MD Anderson Cancer Center, Texas, USA
⁶ Department of Biostatistics, The University of Texas – MD Anderson Cancer Center, Texas, USA
⁷ Sagol School of Neuroscience and School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel

Correspondence Address:
Juan P Cata
Department of Anesthesiology and Perioperative Medicine, The University of Texas – MD Anderson Cancer Center, Houston, Texas 77030
USA

Source of Support: None, Conflict of Interest: None

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DOI: 10.4103/joacp.JOACP_299_16

Background and Aims: The aim is to evaluate the association between the use of intraoperative dexmedetomidine with an increase in recurrence-free survival (RFS) and overall survival (OS) after nonsmall cell lung cancer (NSCLC) surgery. Material and Methods: This was a propensity score-matched (PSM) retrospective study. Single academic center. The study comprised patients with Stage I through IIIa NSCLC. Patients were excluded if they were younger than 18 years. Primary outcomes of the study were RFS and OS. RFS and OS were evaluated using univariate and multivariate Cox proportional hazards models after PSM (n = 251/group) to assess the association between intraoperative dexmedetomidine use and the primary outcomes. The value of P < 0.05 was considered statistically significant. Results: After PSM and adjusting for significant covariates, the multivariate analysis demonstrated no association between the use of dexmedetomidine and RFS (hazard ratio [HR] [95% confidence interval (CI)]: HR = 1.18, 95% CI: 0.91–1.53; P = 0.199). The multivariate analysis also demonstrated an association between the administration of dexmedetomidine and reduced OS (HR = 1.28, 95% CI: 1.03–1.59; P = 0.024). Conclusions: This study demonstrated that the intraoperative use of dexmedetomidine to NSCLC patients was not associated with a significant impact on RFS and but worsening OS. A randomized controlled study should be conducted to confirm the results of this study.

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