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  • 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

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Anaesthesia
Protocol
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
  1. Bruno Luís de Castro Araujo1,
  2. Jadivan Leite de Oliveira2,
  3. Flavia de Miranda Corrêa3,
  4. Luis Eduardo Santos Fontes4,
  5. Andreia Cristina de Melo5,
  6. Luiz Claudio Santos Thuler5,6
  1. 1 Department of Anaesthesiology, Hospital do Câncer II, National Cancer Institute of Brazil (INCA), Rio de Janeiro, Brazil
  2. 2 Connective and Bone Tissue Section, Hospital do Câncer II, National Cancer Institute of Brazil (INCA), Rio de Janeiro, Brazil
  3. 3 Health Technology Assessment Unit, Population Research Division, National Cancer Institute of Brazil (INCA), Rio de Janeiro, Brazil
  4. 4 Department of Evidence‐Based Medicine, Intensive Care, Gastroenterology, Petrópolis Medical School, Rio de Janeiro, Brazil
  5. 5 Clinical Research Division, National Cancer Institute of Brazil (INCA), Rio de Janeiro, Brazil
  6. 6 Postgraduate Program in Neurosciences, Federal University of Rio de Janeiro State, Rio de Janeiro, Brazil
  1. Correspondence to Bruno Luís de Castro Araujo; brunoaraujomed{at}yahoo.com.br

Abstract

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.

  • melanoma
  • analgesia
  • anaesthesia
  • cancer
  • survival
  • recurrence

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/bmjopen-2018-027993

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    Footnotes

    • Contributors BLCA is the guarantor of the review and drafted the manuscript. All authors contributed to the inclusion criteria, the risk of bias assessment and data extraction strategies. FMC and LESF contributed with their knowledge on systematic reviews. LCST and FMC will contribute with epidemiological and statistical analysis. ACM contributed through expertise in medical, and JLO, through expertise in surgical oncology. BA contributed with anaesthetic knowledge. BLCA and JLO will screen potential studies, perform duplicate independent data extraction, risk of bias assessment, GRADE assessment. LCST will act as a third reviewer and arbitrator if necessary. All authors read, provided comments and approved the final version of the protocol.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Patient consent for publication Not required.

    • Patient and public involvement Patients and public were not involved in the development of this systematic review protocol.