Association between intraoperative dexamethasone and long-term survival in non-small cell lung cancer patients undergoing curative resection
10.3969/j.issn.1006-5725.2025.05.016
- VernacularTitle:术中使用地塞米松对非小细胞肺癌患者术后长期生存的影响
- Author:
Yang HUANG
1
;
Ge QU
1
;
Peizong WANG
1
;
Weian ZENG
1
;
Fang YAN
1
Author Information
1. 华南恶性肿瘤防治全国重点实验室、广东省恶性肿瘤临床医学研究中心、中山大学肿瘤防治中心手术麻醉科(广东 广州 510060)
- Publication Type:Journal Article
- Keywords:
intraoperative;
dexamethasone;
non-small cell lung cancer;
survival;
propensity-score matching
- From:
The Journal of Practical Medicine
2025;41(5):724-730
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the association between intraoperative dexamethasone administration and long-term survival outcomes.Methods A total of 1 629 NSCLC patients who underwent lung tumor resection between January 2008 and December 2014 were included in this study.A propensity score-matched cohort was generated at a ratio of 1∶2 to compare patients who received dexamethasone with those who did not.This matching process resulted in a cohort of 532 patients in the non-DEX group and 283 patients in the DEX group.Within this propensity score-matched cohort,disease-free survival(DFS)and overall survival(OS)were compared between the non-DEX and DEX groups using the Kaplan-Meier method.Additionally,Cox proportional hazards regression analysis was used to evaluate the associations between intraoperative administration of dexamethasone and high-risk factors for postoperative nausea and vomiting(PONV),as well as their impact on DFS and OS.Results After propensity score matching,intraoperative dexamethasone was significantly associated with worse OS(P=0.005),while no significant correlation was observed between intraoperative dexamethasone and DFS.Multivariate Cox regression analyses indicated that intraoperative dexamethasone was associated with poorer overall survival(HR=1.233,95%CI:1.002～1.516,P=0.048).In subgroup analyses,intraoperative dexamethasone was significantly associated with shorter OS in the female,video-assisted thoracoscopic surgery(VATS),prolonged anesthetic time,and inhalation anesthesia subgroups.Conclusions There was a significant correlation between intraopera-tive dexamethasone administration and overall survival in NSCLC patients following curative surgery.In high-risk subgroups for PONV,including females,those undergoing VATS,patients with prolonged anesthetic duration,and those under inhalation anesthesia,the administration of intraoperative dexamethasone was associated with a potentially poorer prognosis compared to patients who did not receive intraoperative dexamethasone.
