Impact of propofol‐based vs. volatile‐based anaesthesia on survival and recurrence after cancer surgery: a systematic review and meta‐analysis of randomised trials
- 1School of Medicine, Deakin University Waurn Ponds Melbourne VIC Australia
- 2Anaesthetic and Pain Department St. Vincent's Hospital Melbourne Fitzroy Melbourne VIC Australia
- 3Anaesthetic Department Lismore Base Hospital Lismore NSW Australia
Abstract
Introduction: Choice of peri‐operative anaesthetic technique may influence cancer recurrence, survival and mortality following curative surgery. Conflicting evidence exists on whether propofol‐based anaesthesia improves outcomes over volatile anaesthesia. This systematic review and meta‐analysis examined evidence from randomised trials on overall survival and recurrence in adult patients having oncological surgery.
Methods: We systematically searched relevant databases for randomised trials comparing propofol‐based with volatile‐based anaesthesia in adults undergoing curative cancer surgery. In addition to narrative synthesis, random‐effects meta‐analysis was performed with exploratory trial sequential analysis.
Results: Eleven studies were included, comprising 3904 and 3907 patients assigned to propofol‐based or volatile‐based anaesthesia, respectively. Meta‐analysis found no significant effect on overall or recurrence‐free survival with a hazard ratio of 1.05 (95%CI 0.94–1.17, p = 0.42) and 1.06 (95%CI 0.95–1.19, p = 0.31), respectively. There was no significant effect on mortality (relative risk 1.03, 95%CI 0.94–1.13, p = 0.48). Similar results were found for recurrence (relative risk 0.92, 95%CI 0.76–1.12, p = 0.41). There was minimal detected heterogeneity in all analyses.
Discussion: Propofol‐based and volatile‐based anaesthesia yield similar long‐term oncological outcomes, with no significant differences in survival or recurrence and minimal heterogeneity, supported by high‐certainty evidence. Trial sequential analysis confirms mortality findings are robust while recurrence remains inconclusive.
Related
- Comparative safety and sedation-related outcomes of fospropofol disodium versus propofol for adult sedation outside general anaesthesia induction or maintenance (including ICU and procedural sedation): a systematic review, meta-analysis and trial sequential analysis
- Perioperative Cerebral Metabolism in Patients Under General Anaesthesia With Sevoflurane or Propofol: Evaluation of the Arterial and Jugular Bulb Metabolome.
- Propofol Target-Controlled Infusion with the Eleveld Model in Opioid-Sparing and Opioid-Free Anaesthesia: A Narrative Review
- Tonsillectomy postoperative analgesia study: protocol for a double-blinded, randomised controlled trial comparing ropivacaine and lidocaine as local anaesthesia regarding postoperative pain outcome after tonsillectomy
- Comparison of Postoperative Analgesic Efficacy Between Opioid-free Anaesthesia Using Intravenous Magnesium, Lidocaine, and Erector Spinae Plane Block, and Opioid-based Anaesthesia in Laparoscopic Abdominal Surgeries: A Randomised Controlled Trial
BibTeX
@article{mustafa2026impact,
title = {{Impact of propofol‐based vs. volatile‐based anaesthesia on survival and recurrence after cancer surgery: a systematic review and meta‐analysis of randomised trials}},
author = {Ashmit Daiyan Mustafa and Pavan Shet and Sameen Shadman Sawdagar},
journal = {Anaesthesia},
year = {2026},
month = aug,
doi = {10.1111/anae.70347},
url = {https://doi.org/10.1111/anae.70347},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - Impact of propofol‐based vs. volatile‐based anaesthesia on survival and recurrence after cancer surgery: a systematic review and meta‐analysis of randomised trials
AU - Ashmit Daiyan Mustafa
AU - Pavan Shet
AU - Sameen Shadman Sawdagar
PY - 2026
DA - 2026/08/17
JO - Anaesthesia
DO - 10.1111/anae.70347
UR - https://doi.org/10.1111/anae.70347
AB - Introduction: Choice of peri‐operative anaesthetic technique may influence cancer recurrence, survival and mortality following curative surgery. Conflicting evidence exists on whether propofol‐based anaesthesia improves outcomes over volatile anaesthesia. This systematic review and meta‐analysis examined evidence from randomised trials on overall survival and recurrence in adult patients having oncological surgery. Methods: We systematically searched relevant databases for randomised trials comparing propofol‐based with volatile‐based anaesthesia in adults undergoing curative cancer surgery. In addition to narrative synthesis, random‐effects meta‐analysis was performed with exploratory trial sequential analysis. Results: Eleven studies were included, comprising 3904 and 3907 patients assigned to propofol‐based or volatile‐based anaesthesia, respectively. Meta‐analysis found no significant effect on overall or recurrence‐free survival with a hazard ratio of 1.05 (95%CI 0.94–1.17, p = 0.42) and 1.06 (95%CI 0.95–1.19, p = 0.31), respectively. There was no significant effect on mortality (relative risk 1.03, 95%CI 0.94–1.13, p = 0.48). Similar results were found for recurrence (relative risk 0.92, 95%CI 0.76–1.12, p = 0.41). There was minimal detected heterogeneity in all analyses. Discussion: Propofol‐based and volatile‐based anaesthesia yield similar long‐term oncological outcomes, with no significant differences in survival or recurrence and minimal heterogeneity, supported by high‐certainty evidence. Trial sequential analysis confirms mortality findings are robust while recurrence remains inconclusive.
SN - 0003-2409
SN - 1365-2044
ER -