Effects of the anesthesia on the overall survival and recurrence of lung cancer: meta-analysis

<bold>Background:</bold> Lung cancer (LC) remains the primary cause of cancer mortality globally. Anesthetic choice during thoracotomy may influence LC patient survival, specifically overall survival (OS) and recurrence-free survival (RFS). <bold>Objective:</bold> To assess the impact of different types of anesthesia on OS and RFS in LC surgery. <bold>Methods:</bold> PubMed, WOS, Scopus, and Embase databases have been searched for relevant articles. The main outcomes assessed were OS rates and RFS rates. The random effects model was utilized to estimate survival rates and hazard ratios (HR) for different anesthesia types. <bold>Results:</bold> 14 studies involving 15.910 patients were included in this meta-analysis. The random effects model estimated an overall survival rate of 0.73 (95%CI:0.68-0.78). A decrease in survival rates was observed over time, with a decline from a one-year survival rate of 0.89 to a 10-year survival rate of 0.40. The recurrence-free survival rate was estimated at 0.64 (95%CI:0.59-0.69), with similar declines observed over time. Patients receiving total intravenous anesthesia (TIVA) had a crude unadjusted HR for OS of 1.24 (95%CI:1.04-1.47), indicating a significant association with decreased survival compared to inhaled anesthesia (INHA). However, there was no significant association found between the anesthesia method and RFS (HR: 1.11, 95%CI:0.88-1.40). <bold>Conclusions:</bold> This stuyd suggests that the type of anesthesia administered during LC surgery may have a significant effect on OS rates, with TIVA associated with decreased survival compared to INHA. These findings underscore the importance of considering anesthesia type in the management of LC patients to optimize long-term outcomes.