Scalp block for glioblastoma surgery is associated with lower inflammatory scores and improved survival

Lan Zheng, Katherine B. Hagan, John Villarreal, Visesh Keerty, Jasper Chen, Juan P. Cata

Research output: Contribution to journalArticlepeer-review

23 Scopus citations

Abstract

BACKGROUND: Regional anesthesia has anti-inflammatory effects. Recent studies suggest that regional anesthesia might improve the survival of patients with cancer. We hypothesized that the use of a scalp block (SB) during craniotomy for glioblastoma (GB) decreases the postoperative systemic and local inflammatory response and extend their survival. METHODS: This retrospective study included 119 patients with GB who underwent tumor resection. We divided patients into 2 groups based on the use of SB during surgery. Preoperative and postoperative neutrophil-to-lymphocyte (NLR) ratio and platelet-to-lymphocyte (PLR) ratios were calculated as well as the percentage change in postoperative T2/FLAIR (FLuid-Attenuated Inversion Recovery) volume. Both markers of the inflammatory response were compared between patients with and without an SB. Progression-free survival (PFS) was also compared in both groups of patients. Univariate and multivariate analysis were used to test the association between SB and patients' survival. RESULTS: On day 3 after surgery, patients who had an SB showed statistically significant lower NLRs and PLRs than those without an SB. There was also a significant larger reduction in postoperative T2/FLAIR signal in patients with SB than in those without SB. The median PFS (progression-free survival) was longer in patients with SB (16.7 months) than those without an SB (6.5 months, P<0.001). The multivariate analysis indicated that the use of SB was an independent factor for longer PFS (hazard ratio: 0.31 95% confidence interval: 0.07-0.21, P<0.001). CONCLUSIONS: This retrospective study supports the hypothesis that in patients with GB undergoing craniotomy, the use of SB is associated with lower levels of systemic and local inflammation, and longer survival.

Original languageEnglish (US)
Pages (from-to)1137-1145
Number of pages9
JournalMinerva Anestesiologica
Volume83
Issue number11
DOIs
StatePublished - Nov 2017

Keywords

  • Anesthesia
  • Craniotomy
  • Glioblastoma
  • Inflammation
  • Local
  • Recurrence.
  • Scalp

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

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