Perspectives in anaesthesia for cancer surgery

Area of Science:

• Oncology
• Surgical Oncology
• Inflammation Research

Background:

• Inflammatory scores are critical prognostic indicators in cancer surgery.
• Inflammation plays a causative and concomitant role in various cancers.
• Preoperative inflammatory status can be monitored using simple parameters like the neutrophil/lymphocyte ratio.

Purpose of the Study:

• To highlight the prognostic significance of preoperative inflammation in cancer patients.
• To introduce the neutrophil/lymphocyte ratio as a practical biomarker for patient stratification and clinical trials.
• To explore the potential benefits of non-steroidal anti-inflammatory drugs in cancer treatment.

Main Methods:

• Analysis of existing data and database studies on perioperative inflammation.
• Correlation analysis between non-steroidal anti-inflammatory drug use (specifically ketorolac) and patient outcomes.
• Identification of high-risk patient groups based on preoperative inflammatory markers.

Main Results:

• A correlation was observed between ketorolac use and improved metastasis-free and overall survival in breast and lung cancer patients.
• The neutrophil/lymphocyte ratio serves as a valuable tool for assessing preoperative inflammatory status.
• Database analyses provide rationale for ongoing clinical trials investigating perioperative inflammation.

Conclusions:

• Preoperative inflammation assessment is crucial for cancer patient prognostication.
• Ketorolac shows promise in improving outcomes for specific cancer types.
• Targeting high-risk patients with preoperative inflammation using ketorolac warrants further clinical investigation.