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Association between intraoperative dexamethasone and long-term survival in non-small cell lung cancer patients undergoing curative resection
Received date: 2025-01-09
Online published: 2025-03-20
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 intraoperative 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.
Yang HUANG , Ge QU , Peizong WANG , Weian ZENG , Fang. YAN . Association between intraoperative dexamethasone and long-term survival in non-small cell lung cancer patients undergoing curative resection[J]. The Journal of Practical Medicine, 2025 , 41(5) : 724 -730 . DOI: 10.3969/j.issn.1006-5725.2025.05.016
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