Impact of general anaesthesia in overall and disease-free survival compared to other types of anaesthesia in patients undergoing surgery for cutaneous melanoma: a systematic review and meta-analysis protocol

Introduction Cutaneous melanoma is an aggressive type of skin cancer. Anaesthetic agents may have an impact on the immune response, postoperative neurohumoral response and tumour progression. This systematic review aims to evaluate the impact of general anaesthesia on overall and disease-free surviv...

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Main Authors: Bruno Luís de Castro Araujo, Jadivan Leite de Oliveira, Flavia de Miranda Corrêa, Luis Eduardo Santos Fontes, Andreia Cristina de Melo, Luiz Claudio Santos Thuler
Format: Article
Language:English
Published: BMJ Publishing Group 2019-07-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/9/7/e027993.full
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author Bruno Luís de Castro Araujo
Jadivan Leite de Oliveira
Flavia de Miranda Corrêa
Luis Eduardo Santos Fontes
Andreia Cristina de Melo
Luiz Claudio Santos Thuler
author_facet Bruno Luís de Castro Araujo
Jadivan Leite de Oliveira
Flavia de Miranda Corrêa
Luis Eduardo Santos Fontes
Andreia Cristina de Melo
Luiz Claudio Santos Thuler
author_sort Bruno Luís de Castro Araujo
collection DOAJ
description Introduction Cutaneous melanoma is an aggressive type of skin cancer. Anaesthetic agents may have an impact on the immune response, postoperative neurohumoral response and tumour progression. This systematic review aims to evaluate the impact of general anaesthesia on overall and disease-free survival compared with other types anaesthesia in patients undergoing surgery for cutaneous melanoma.Methods and analysis The review will analyse data from controlled and observational studies of patients undergoing surgery for melanoma under general anaesthesia compared with other types of anaesthesia. The primary outcomes are overall survival and disease-free survival. The secondary outcomes are health-related quality of life, time to tumour progression, distant disease-free survival, time to treatment failure, cancer-specific survival, biochemical recurrence, return of intended oncological therapy, days alive and out of the hospital at 90 days, cost analysis and adverse events. A comprehensive literature search will be performed using the MEDLINE, EMBASE, Cochrane CENTRAL, Web of Science, LILACS and IBECS databases. Grey literature will also be searched. Risk of methodological bias will be assessed using The Cochrane Collaboration’s revised tool for assessing risk of bias in randomised trials (RoB 2.0) and the Newcastle–Ottawa scale. Two reviewers will independently assess the eligibility of studies and risk of bias; a third author will solve discrepancies. One author will perform data extraction and the other will check the process and data. Qualitative analysis will be carried out using all included studies. A meta-analysis using a random-effects model for pooled risk estimates will be carried out for the two main outcomes and for selected secondary outcomes if they conform to previously stated criteria. The GRADE approach will be used to summarise the quality of evidence.Ethics and dissemination Ethics approval is not required as we analyse data from previously reported studies.PROSPERO registration number CRD42018114918.
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spelling doaj-art-fb29bbf81a704a2b882275777d949dfe2025-08-20T02:18:43ZengBMJ Publishing GroupBMJ Open2044-60552019-07-019710.1136/bmjopen-2018-027993Impact of general anaesthesia in overall and disease-free survival compared to other types of anaesthesia in patients undergoing surgery for cutaneous melanoma: a systematic review and meta-analysis protocolBruno Luís de Castro Araujo0Jadivan Leite de Oliveira1Flavia de Miranda Corrêa2Luis Eduardo Santos Fontes3Andreia Cristina de Melo4Luiz Claudio Santos Thuler51 Department of Anaesthesiology, Hospital do Câncer II, National Cancer Institute of Brazil (INCA), Rio de Janeiro, Brazil2 Connective and Bone Tissue Section, Hospital do Câncer II, National Cancer Institute of Brazil (INCA), Rio de Janeiro, Brazil3 Health Technology Assessment Unit, Population Research Division, National Cancer Institute of Brazil (INCA), Rio de Janeiro, BrazilCentro Universitário Arthur Sá Earp Neto, UNIFASE, Petropolis, BrasilLatin American Cooperative Oncology Group, Porto Alegre, Rio Grande do Sul, BrazilProgram of Clinical Epidemiology, Brazilian National Cancer Institute, Rio de Janeiro, BrazilIntroduction Cutaneous melanoma is an aggressive type of skin cancer. Anaesthetic agents may have an impact on the immune response, postoperative neurohumoral response and tumour progression. This systematic review aims to evaluate the impact of general anaesthesia on overall and disease-free survival compared with other types anaesthesia in patients undergoing surgery for cutaneous melanoma.Methods and analysis The review will analyse data from controlled and observational studies of patients undergoing surgery for melanoma under general anaesthesia compared with other types of anaesthesia. The primary outcomes are overall survival and disease-free survival. The secondary outcomes are health-related quality of life, time to tumour progression, distant disease-free survival, time to treatment failure, cancer-specific survival, biochemical recurrence, return of intended oncological therapy, days alive and out of the hospital at 90 days, cost analysis and adverse events. A comprehensive literature search will be performed using the MEDLINE, EMBASE, Cochrane CENTRAL, Web of Science, LILACS and IBECS databases. Grey literature will also be searched. Risk of methodological bias will be assessed using The Cochrane Collaboration’s revised tool for assessing risk of bias in randomised trials (RoB 2.0) and the Newcastle–Ottawa scale. Two reviewers will independently assess the eligibility of studies and risk of bias; a third author will solve discrepancies. One author will perform data extraction and the other will check the process and data. Qualitative analysis will be carried out using all included studies. A meta-analysis using a random-effects model for pooled risk estimates will be carried out for the two main outcomes and for selected secondary outcomes if they conform to previously stated criteria. The GRADE approach will be used to summarise the quality of evidence.Ethics and dissemination Ethics approval is not required as we analyse data from previously reported studies.PROSPERO registration number CRD42018114918.https://bmjopen.bmj.com/content/9/7/e027993.full
spellingShingle Bruno Luís de Castro Araujo
Jadivan Leite de Oliveira
Flavia de Miranda Corrêa
Luis Eduardo Santos Fontes
Andreia Cristina de Melo
Luiz Claudio Santos Thuler
Impact of general anaesthesia in overall and disease-free survival compared to other types of anaesthesia in patients undergoing surgery for cutaneous melanoma: a systematic review and meta-analysis protocol
BMJ Open
title Impact of general anaesthesia in overall and disease-free survival compared to other types of anaesthesia in patients undergoing surgery for cutaneous melanoma: a systematic review and meta-analysis protocol
title_full Impact of general anaesthesia in overall and disease-free survival compared to other types of anaesthesia in patients undergoing surgery for cutaneous melanoma: a systematic review and meta-analysis protocol
title_fullStr Impact of general anaesthesia in overall and disease-free survival compared to other types of anaesthesia in patients undergoing surgery for cutaneous melanoma: a systematic review and meta-analysis protocol
title_full_unstemmed Impact of general anaesthesia in overall and disease-free survival compared to other types of anaesthesia in patients undergoing surgery for cutaneous melanoma: a systematic review and meta-analysis protocol
title_short Impact of general anaesthesia in overall and disease-free survival compared to other types of anaesthesia in patients undergoing surgery for cutaneous melanoma: a systematic review and meta-analysis protocol
title_sort impact of general anaesthesia in overall and disease free survival compared to other types of anaesthesia in patients undergoing surgery for cutaneous melanoma a systematic review and meta analysis protocol
url https://bmjopen.bmj.com/content/9/7/e027993.full
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