Could there be a relationship between type of anesthesia and oncological parameters after transurethral resection of bladder cancer?

Cancer progression can be affected by a number of factors that cannot be totally explained. Growing evidence in the literature reports that, among various parameters, type of anesthesia and perioperative pain control may alter prognosis of different type of cancers (1-4). In their article, Koumpan et al. showed that patients with the diagnosis of non-muscle invasive bladder cancer (NMIBC) who underwent transurethral resection of bladder tumour (TURBT) under spinal anesthesia had lower recurrence rates and delayed time-to-recurrence compared to the ones who were offered the same procedure under general anesthesia (5). No difference was found between the two groups in terms of disease progression to muscle-invasive stage and overall mortality. Authors used multivariable logistic regression and Cox proportional hazards ration model to assess the association between anesthetic type and recurrence and time to recurrence, respectively