{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T18:30:07Z","timestamp":1740162607581,"version":"3.37.3"},"reference-count":28,"publisher":"BMJ","issue":"7","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2019,7,3]]},"published-print":{"date-parts":[[2019,7]]},"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and analysis<\/jats:title><jats:p>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\u2019s revised tool for assessing risk of bias in randomised trials (RoB 2.0) and the Newcastle\u2013Ottawa 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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Ethics and dissemination<\/jats:title><jats:p>Ethics approval is not required as we analyse data from previously reported studies.<\/jats:p><\/jats:sec><jats:sec><jats:title>PROSPERO registration number<\/jats:title><jats:p>CRD42018114918.<\/jats:p><\/jats:sec>","DOI":"10.1136\/bmjopen-2018-027993","type":"journal-article","created":{"date-parts":[[2019,7,27]],"date-time":"2019-07-27T15:55:20Z","timestamp":1564242920000},"page":"e027993","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"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"],"prefix":"10.1136","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9035-136X","authenticated-orcid":false,"given":"Bruno Lu\u00eds de Castro","family":"Araujo","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jadivan Leite","family":"de Oliveira","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Flavia de Miranda","family":"Corr\u00eaa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luis Eduardo Santos","family":"Fontes","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andreia Cristina","family":"de Melo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luiz Claudio Santos","family":"Thuler","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2019,7,27]]},"reference":[{"key":"2024052012262327000_9.7.e027993.1","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1007\/s11912-018-0732-8","article-title":"The world of melanoma: epidemiologic, genetic, and anatomic differences of melanoma across the globe","volume":"20","author":"Dimitriou","year":"2018","journal-title":"Curr Oncol Rep"},{"key":"2024052012262327000_9.7.e027993.2","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21492"},{"key":"2024052012262327000_9.7.e027993.3","doi-asserted-by":"crossref","first-page":"472","DOI":"10.3322\/caac.21409","article-title":"Melanoma staging: evidence-based changes in the American Joint Committee on Cancer eighth edition cancer staging manual","volume":"67","author":"Gershenwald","year":"2017","journal-title":"CA Cancer J Clin"},{"key":"2024052012262327000_9.7.e027993.4","doi-asserted-by":"crossref","first-page":"932","DOI":"10.1097\/ALN.0000000000002357","article-title":"Propofol-based total intravenous anesthesia is associated with better survival than desflurane anesthesia in colon cancer surgery","volume":"129","author":"Wu","year":"2018","journal-title":"Anesthesiology"},{"key":"2024052012262327000_9.7.e027993.5","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1186\/s12871-018-0543-3","article-title":"Effect of propofol on breast cancer cell, the immune system, and patient outcome","volume":"18","author":"Li","year":"2018","journal-title":"BMC Anesthesiol"},{"key":"2024052012262327000_9.7.e027993.6","doi-asserted-by":"publisher","DOI":"10.1097\/AAP.0b013e31829cc3fb"},{"key":"2024052012262327000_9.7.e027993.7","doi-asserted-by":"crossref","first-page":"1341","DOI":"10.1245\/s10434-014-4112-9","article-title":"Anesthetic selection and disease-free survival following optimal primary cytoreductive surgery for stage III epithelial ovarian cancer","volume":"22","author":"Elias","year":"2015","journal-title":"Ann Surg Oncol"},{"key":"2024052012262327000_9.7.e027993.8","first-page":"16:16","article-title":"A comparison of regional and general anesthesia effects on 5 year survival and cancer recurrence after transurethral resection of the bladder tumor: a retrospective analysis","volume":"16","author":"Jang","year":"2016","journal-title":"BMC Anesthesiol"},{"key":"2024052012262327000_9.7.e027993.9","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0114667","article-title":"Comparison of combined general-epidural anesthesia with general anesthesia effects on survival and cancer recurrence: a meta-analysis of retrospective and prospective studies","volume":"9","author":"Pei","year":"2014","journal-title":"PLoS One"},{"key":"2024052012262327000_9.7.e027993.10","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aes176"},{"key":"2024052012262327000_9.7.e027993.11","doi-asserted-by":"publisher","DOI":"10.1111\/cen.13820"},{"key":"2024052012262327000_9.7.e027993.12","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0156152","article-title":"A systematic review of the modifying effect of anaesthetic drugs on metastasis in animal models for cancer","volume":"11","author":"Hooijmans","year":"2016","journal-title":"PLoS One"},{"key":"2024052012262327000_9.7.e027993.13","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpa.2013.10.005"},{"key":"2024052012262327000_9.7.e027993.14","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.26448"},{"key":"2024052012262327000_9.7.e027993.15","doi-asserted-by":"crossref","first-page":"503","DOI":"10.1080\/0284186X.2017.1301680","article-title":"HIF-1 in cancer therapy: two decade long story of a transcription factor","volume":"56","author":"Soni","year":"2017","journal-title":"Acta Oncol"},{"key":"2024052012262327000_9.7.e027993.16","doi-asserted-by":"publisher","DOI":"10.1007\/BF03014331"},{"key":"2024052012262327000_9.7.e027993.17","first-page":"630","article-title":"Propofol promotes apoptosis and suppresses the HOTAIR-mediated mTOR\/p70S6K signaling pathway in melanoma cells","volume":"15","author":"Shang","year":"2018","journal-title":"Oncol Lett"},{"key":"2024052012262327000_9.7.e027993.18","doi-asserted-by":"crossref","first-page":"594","DOI":"10.1016\/j.bjan.2016.08.002","article-title":"Cytotoxic effects of local anesthesia through lidocaine\/ropivacaine on human melanoma cell lines","volume":"66","author":"Kang","year":"2016","journal-title":"Braz J Anesthesiol"},{"key":"2024052012262327000_9.7.e027993.19","first-page":"137","article-title":"[Comparative analysis of narcosis and local anesthesia in surgery of malignant melanoma of the skin]","volume":"41","author":"Seebacher","year":"1990","journal-title":"Hautarzt"},{"key":"2024052012262327000_9.7.e027993.20","doi-asserted-by":"publisher","DOI":"10.1097\/00008390-200004000-00009"},{"key":"2024052012262327000_9.7.e027993.21","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1684\/ejd.2018.3250","article-title":"Lymph node dissection for melanoma using tumescence local anaesthesia: an observational study","volume":"28","author":"Kofler","year":"2018","journal-title":"Eur J Dermatol"},{"key":"2024052012262327000_9.7.e027993.22","doi-asserted-by":"publisher","DOI":"10.1186\/2046-4053-4-1"},{"key":"2024052012262327000_9.7.e027993.23","doi-asserted-by":"publisher","DOI":"10.1001\/jama.283.15.2008"},{"key":"2024052012262327000_9.7.e027993.24","unstructured":"Higgins JPT , Green S , eds. Cochrane handbook for systematic reviews of interventions version 5.1.0: The Cochrane Collaboration, 2011."},{"key":"2024052012262327000_9.7.e027993.25","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1016\/j.bja.2018.03.020","article-title":"Systematic review and consensus definitions for standardised endpoints in perioperative medicine: postoperative cancer outcomes","volume":"121","author":"Buggy","year":"2018","journal-title":"Br J Anaesth"},{"key":"2024052012262327000_9.7.e027993.26","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.39490.551019.BE"},{"key":"2024052012262327000_9.7.e027993.27","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1016\/j.jclinane.2017.08.001","article-title":"Outcomes of cancer surgery after inhalational and intravenous anesthesia: a systematic review","volume":"42","author":"Soltanizadeh","year":"2017","journal-title":"J Clin Anesth"},{"key":"2024052012262327000_9.7.e027993.28","doi-asserted-by":"publisher","DOI":"10.1097\/AAP.0000000000000273"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2018-027993","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,20]],"date-time":"2024-05-20T19:40:23Z","timestamp":1716234023000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2018-027993"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,7]]},"references-count":28,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2019,7,27]]},"published-print":{"date-parts":[[2019,7]]}},"alternative-id":["10.1136\/bmjopen-2018-027993"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2018-027993","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"type":"print","value":"2044-6055"},{"type":"electronic","value":"2044-6055"}],"subject":[],"published":{"date-parts":[[2019,7]]}}}