A multicentre, prospective randomized, active-controlled feasibility trial of volatile-based anaesthesia vs. propofol-based total intravenous anaesthesia to investigate the impact of anaesthesia on long-term (i.e. 5-years) patient cancer outcomes in patients undergoing elective major cancer surgery.

This study aims to assess the feasibility of conducting a phase IV, multi-centre, single-blinded, randomized control trial (VAPOR-C (Main)).

Primary aims To measure the ability to recruit eligible patients into the study.

To measure the ability to successfully deliver each of the two anaesthetic techniques (volatile-based general anaesthesia and propofol-based anaesthesia) according to the research protocol.

Inclusion Criteria:

• Male or female
• Age 18-80 years
• Elective surgery
• Major cancer surgery expecting to last two or more hours, for:
• Breast (mastectomy or segmentectomy plus sentinel node dissection)
• Colorectal
• Lung
• Prostate
• Melanoma (excision of melanoma plus lymph node dissection AND/OR skin flap construction
• Other major cancer surgeries (e.g. oesophagectomy, head and neck cancer, etc.)

Exclusion Criteria

• Palliative surgery for end-stage disease with no curative intent
• Emergency surgery
• Extensive comorbid disease, i.e. American Society of Anesthesiologists (ASA) Score > 4
• Age <18 or >80 years old
• Refusal or inability to provide valid informed consent
• Risk of severe postoperative nausea and vomiting (PONV risk score >3)
• Previous allergy or contraindication to either anaesthetic medication
• Indication for gas induction of anaesthesia
• Currently enrolled in another clinical trial unless agreed by the coordinating principal investigator and site principal investigator that co-enrolment can occur.

Patients are blinded to the anaesthetic type given. Statistician also blinded.