The study compares the effect of total intravenous anesthesia (TIVA) and combined inhalation and intravenous anesthesia (CIVA) on the survival of patients after cancer surgery. A retrospective cohort study in a Chinese hospital included 25,351 patients operated from January 2014 to December 3, 2018, of which 23,790 received TIVA and 1,561 CIVA. After 1:3 propensity score adjustment (PSM), there were 1,536 patients with CIVA and 4,519 with TIVA. CIVA was not associated with short-term mortality, but Cox regression models showed an association with long-term mortality. A multivariable model after 1:3 PSM revealed an increased risk of 3-year mortality in CIVA (HR: 1.220; 95% CI: 1.043–1.404). Previous studies suggest that inhalation anesthesia may increase the risk of metastasis and shorten survival. The study highlights the need for further prospective research due to the retrospective design.