Background: Previous studies have shown that
anesthetic techniques can affect outcomes of
cancer surgery. We investigated the association between
anesthetic techniques and patient outcomes after elective
epithelial ovarian cancer surgery. Methods: This was a retrospective cohort study of patients who received elective open surgery for
epithelial ovarian cancer between January 2009 and December 2014. Patients were grouped according to the administration of
propofol or
desflurane anesthesia. Kaplan-Meier analysis was performed, and survival curves were constructed from the date of surgery to death. Univariate and multivariate Cox regression models were used to compare hazard ratios for death after propensity matching. Subgroup analyses were performed for age, body mass index, preoperative
carbohydrate antigen-125 level, International Federation of Gynecology and Obstetrics staging, and operation and
anesthesia time. Results: In total, 165 patients (76 deaths, 46.1%) who received
desflurane anesthesia and 119 (30 deaths, 25.2%) who received
propofol anesthesia were eligible for analysis. After propensity matching, 104 patients were included in each group. In the matched analysis, patients who received
propofol anesthesia had better survival with a hazard ratio of 0.52 (95% confidence interval, 0.33-0.81; p = 0.005). Subgroup analyses also showed significantly better survival with old age, high body mass index, elevated
carbohydrate antigen-125 level, advanced International Federation of Gynecology and Obstetrics stage, and prolonged operation and
anesthesia time in the matched
propofol group. In addition, patients administered with
propofol anesthesia had less postoperative recurrence and
metastasis than those administered with
desflurane anesthesia in the matched analysis. Conclusion:
Propofol anesthesia was associated with better survival in patients who underwent elective
epithelial ovarian cancer open surgery. Prospective studies are warranted to evaluate the effects of
propofol anesthesia on oncological outcomes in patients with
epithelial ovarian cancer.