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Table 1 Characteristics of included studies

From: Regional anesthesia might reduce recurrence and metastasis rates in adult patients with cancers after surgery: a meta-analysis

Study

Study design

Cancer type

Age,mean

(Intervention ,

Control)

Sample size

(I ,C)

RA technique

PSM

Certainty of the evidence

(GRADE)

length of follow up(month)

Gupta 2011

Retrospective cohort

Colorectal cancer

71.4,73.2

655(562,93)

EA + GA

No

Low

31

Wuethrich 2010

Retrospective cohort

Prostate cancer

63,64

261

EA + GA

No

Low

102

Li 2022

RCT

Breast cancer

48 ± 10

49 ± 9

1253

PVB + GA

No

High

53

de Oliveira 2011

Retrospective cohort

Ovarian cancer

55,57

183

EA + GA

No

Low

42 (IQR12-60)

Mu 2021

Retrospective cohort

Colorectal cancer

60.5 ± 10.5, 61.2 ± 12.8

174

EA + GA

Yes

Low

41(IQR39-43)

Tsui 2010

RCT

Prostate cancer

63.0 ± 5.5

63.9 ± 6.1

99

EA + GA

No

High

54

Wuethrich 2013

Retrospective cohort

Prostate cancer

63.8,63.6

148

EA + GA

No

Low

135 (IQR 14–198)

Hasselager 2022

Prospective cohort

Colorectal cancer

70,70

5960

EA + GA

Yes

Moderate

NA

Macleod 2018

Prospective cohort

Prostate cancer

59.5,60

2909

PVB + GA

No

Moderate

No multimodal analgesia:135 (IQR109–150)

Multimodal analgesia:

55 (IQR29–83)

Biki 2008

Retrospective cohort

Prostate cancer

63 ± 5, 62 ± 6

225

EA + GA

No

Low

33–153

Karmakar 2017

RCT

Breast cancer

52,51

177

PVB + GA

No

High

60

Sessler 2019

RCT

Breast cancer

53,53

2108

EA/LA/SA + GA

No

High

36 (IQR 24–49)

Christopherson 2008

RCT

Colorectal cancer

68.6 ± 7.7, 69.1 ± 7.8

177

EA + GA

No

High

NA

Pei 2020

Retrospective cohort

Gastric cancer

65,75

194

EA + GA

Yes

Low

NA

Exadaktylos 2006

Retrospective cohort

Breast cancer

NA

129

PVB + GA

No

Low

32 ± 5

Gottschalk 2010

Retrospective cohort

Colorectal cancer

65,63

509

EA + GA

No

Low

21(IQR9-46)

Kuo 2014

Retrospective cohort

Hepatocellular carcinoma

63.7 ± 10.7, 64.7 ± 11.7

118

SA

No

Low

24

Lai et al. 2012

Retrospective cohort

Hepatocellular carcinoma

51.5 ± 16.6, 54.9 ± 11.3

179

EA

No

Low

43(IQR2-129)

Koumpan 2018

Retrospective cohort

Bladder Cancer

71.7 ± 10.5, 65.4 ± 10.5

243

SA

No

Low

NA

Tseng 2014

Retrospective cohort

Prostate cancer

58,58

1964

SA

No

Low

48 to 60

Heinrich 2015

Retrospective cohort

Esophageal cancer

61,61

153

EA + GA

No

Low

NA

Hiller 2014

Retrospective cohort

Gastro-oesophageal cancer

67,66

140

EA + GA

No

Moderate

NA

Holler 2013

Retrospective cohort

Colorectal cancer

NA

749

EA + GA

No

Low

NA

Zhang 2021

Retrospective cohort

Breast cancer

54.1, 54.1

2790

PVB-RA

Yes

Low

patients receiving INHA-GA without propofol: 61.2 ± 25.2

patientsreceiving PB-RA with propofol: 62.1 ± 28.1

Sprung 2014

Retrospective cohort

Prostate cancer

63.9, 63.9

387

EA

No

Low

NA

Capmas 2012

Retrospective cohort

Ovarian cancer

56, 56

94

EA + GA

No

Low

33 to 153

Wang 2020

Retrospective cohort

Hepatocellular carcinoma

57.6, 56.1

489

EA/LA/SA

No

Low

NA

Choi 2017

Retrospective cohort

Bladder Cancer

63 ± 12, 61 ± 13

690

SA

Yes

Low

35 (IQR 11–57)

Lu 2021

Retrospective cohort

Breast cancer

45, 45

169

EA

No

Low

more than 60

Karanlik 2017

Case-control

Breast cancer

72.4 ± 6,

71.1 ± 3.7

91

LA

No

Low

GA :55.09 ±

13.49 (IQR 38–104) LA: 58.7 ±

15.5 (IQR 20–99)

Lin 2011

Retrospective cohort

Ovarian cancer

45.7, 48.1

143

EA

No

Low

24 to 174

Lee 2022

Retrospective cohort

Bladder Cancer

66.8 ± 6.1, 66.5 ± 6.1

1164

EA/LA/SA

Yes

High

53 ± 21

  1. EA, epidural anesthesia; GA, general anesthesia; LA, local anesthesia; NOS, Newcastle-Ottawa Scale; PSM, propensity score matching; PVB, paravertebral block; RA, regional anesthesia; RCT, randomized control trial; SA, spinal anesthesia. NA: Not Available. IQR: Inter-Quartile Range
  2. GRADE Working Group grades of evidence
  3. High certainty: we are very confident that the true effect lies close to that of the estimate of the effect
  4. Moderate certainty: we are moderately confident in the effect estimate: the true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different
  5. Low certainty: our confidence in the effect estimate is limited: the true effect may be substantially different from the estimate of the effect
  6. Very low certainty: we have very little confidence in the effect estimate: the true effect is likely to be substantially different from the estimate of effect