Table 2.
Summary of Clinical Studies Comparing TIVA vs Inhalational Anesthesia with Respect to Cancer Outcomes
| Type of Cancer | Author (Year) | Type of Study | Intervention | Overall Survival | Recurrence-Free Survival |
|---|---|---|---|---|---|
| Appendiceal (HIPEC) | Cata (2019)128 | Retrospective | TIVA (Opioid-sparing) vs Inhalational-Opioid | No difference | No difference |
| Breast | Sessler (2019)9 | RCT subanalysis | TIVA vs Inhalational | No difference | No difference |
| Breast | Lee (2016)129 | Retrospective | TIVA vs Inhalational | No difference | Increased with TIVA |
| Breast | Yoo (2019)130 | Retrospective | TIVA vs Inhalational | No difference | No difference |
| Breast | Yan (2018)125 | RCT (Not powered for OS or RFS) | TIVA vs Inhalational | No difference | No difference |
| Cholangiocarcinoma | Lai (2019)131 | Retrospective | TIVA vs Inhalational | Increased with TIVA | TIVA group showed a decreased rate of metastasis. |
| Colorectal | Wu (2018)132 | Retrospective | TIVA vs Inhalational (Desflurane-specific) | Increased with TIVA | Not studied |
| Esophageal | Jun (2017)133 | Retrospective | TIVA vs Inhalational | Increased with TIVA | Increased with TIVA |
| Gastric | Zheng (2018)134 | Retrospective | TIVA vs Inhalational | Increased with TIVA | Not studied |
| Gastric | Oh (2019)135 | Retrospective | TIVA vs Inhalational | No difference | No difference |
| Glioblastoma | Cata (2017)136 | Retrospective | Isoflurane ± Propofol vs Desflurane ± Propofol | No difference | No difference |
| Hepatocellular | Lai (2019)137 | Retrospective | TIVA vs Inhalational (Desflurane-specific) | Increased with TIVA | Increased with TIVA |
| Lung | Oh (2018)138 | Retrospective | TIVA vs Inhalational | No difference | No difference |
| Lung | Xu (2017)139 | RCT (Not powered for OS or RFS) | TIVA vs Epidural/Inhalational | No difference | No difference |
| Multiple (Breast, Esophageal, Lung) | Yap (2019)140 | MA (10 studies) | TIVA vs Inhalational | Increased with TIVA | Pooled data from 6 studies showed increased with TIVA |
| Multiple (Breast, Gastrointestinal, Gynecological, Sarcoma, Urologic, Other) | Wigmore (2016)6 | Retrospective | TIVA vs Inhalational | Increased with TIVA | Not studied |
| Multiple (Breast, Gastrointestinal, Liver, Lung) | Hong (2019)141 | Retrospective | TIVA vs Inhalational | No difference | Not studied |
| Multiple (Breast, Gastrointestinal, Urologic, Glioma, Lung) | Jin (2019)142 | MA (12 studies) | TIVA vs Inhalational | Pooled effects favor TIVA, not individualized by cancer type. | Pooled data from 5 studies on recurrence showed no significant difference. TIVA is favored in breast cancer. Pooled data specifically on RFS on 3 studies favor TIVA. |
| Ovarian | Elias (2015)85 | Retrospective | Inhaled Anesthesia (Sevoflurane/Desflurane) vs TIVA | Not studied | Increased with desflurane |
Abbreviations: RCT, randomized controlled trial; HIPEC, hyperthermic intraperitoneal chemotherapy; TIVA, total intravenous anesthesia; OS, overall survival; RFS, recurrence-free survival; MA, meta-analysis.