Impact of intraoperative dexmedetomidine on clear cell renal cell carcinoma progression: a retrospective cohort study
Recommended Citation
Wong R, Patel RG, Cortes-Mejia N, Guerra-Londono JJ, Huang H, Gundre S, Napa N, and Cata JP. Impact of intraoperative dexmedetomidine on clear cell renal cell carcinoma progression: a retrospective cohort study. Br J Anaesth 2025;135(1):99-108.
Document Type
Article
Publication Date
7-1-2025
Publication Title
British journal of anaesthesia
Abstract
BACKGROUND: Dexmedetomidine, an α-2 adrenoreceptor agonist, is commonly administered during cancer surgery as an adjuvant sedative because of its general anaesthetic agent-sparing effects. We investigated the association between ADRA2 gene expression and dexmedetomidine on oncological outcomes after surgery for clear cell renal cell carcinoma (RCC).
METHODS: We conducted an in silico analysis using a publicly available database and a retrospective study in patients with clear cell RCC. The associations between ADRA2A expression and recurrence-free survival and overall survival were analysed. The same outcomes were investigated in a cohort of patients who underwent partial or total nephrectomy and received dexmedetomidine or not. A propensity score matching strategy was utilised to account for selection bias, and a multivariable analysis was performed to control for variables implicated in survival.
RESULTS: Expression of the ADRA2A gene at the tumour level was not associated with recurrence-free survival; however, higher levels of expression were significantly associated with shorter overall survival. A total of 1766 patients with clear cell RCC were included in the retrospective study. Dexmedetomidine administration was not associated with higher rates of recurrence or mortality or with a significant impact on recurrence-free survival or overall survival.
CONCLUSIONS: Intraoperative administration of dexmedetomidine was not associated with a significant impact on cancer progression and survival. The role of ADRA2A as a prognosis biomarker for clear cell RCC warrants further study.
Medical Subject Headings
Humans; Dexmedetomidine; Carcinoma, Renal Cell; Retrospective Studies; Kidney Neoplasms; Male; Female; Middle Aged; Aged; Receptors, Adrenergic, alpha-2; Nephrectomy; Disease Progression; Intraoperative Care; Adrenergic alpha-2 Receptor Agonists; Cohort Studies; Neoplasm Recurrence, Local; Adult
PubMed ID
40348672
ePublication
ePub ahead of print
Volume
135
Issue
1
First Page
99
Last Page
108
