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Cancer surgery: how may anesthesia influence outcome?
Fernando Cassinello1, Isabel Prieto1, Mercedes del Olmo1
1IDC-Salud Fundacion Jimenez Diaz University Hospital, 28040 Madrid, Spain.
Journal of Clinical Anesthesia
|March 15, 2015
Summary
Anesthesia choice impacts cancer outcomes. While inhaled anesthetics may promote tumor growth, propofol and local anesthetics show protective effects, inhibiting cancer cell proliferation and migration.
Area of Science:
- Anesthesiology
- Oncology
- Cancer Biology
Background:
- Surgery is a primary treatment for solid tumors, but metastatic disease remains a major cause of cancer-related mortality.
- Anesthetic techniques may influence long-term outcomes following cancer surgery.
Purpose of the Study:
- To review the literature on anesthesia's effects on cancer surgery.
- To investigate anesthesia's role in preventing tumor cell proliferation, migration, or inducing apoptosis.
Main Methods:
- Literature review of English-language publications.
- PubMed database search up to January 2014.
- Selection of articles on anesthetics' effects on cancer cells and recurrence/outcome.
Main Results:
- Inhaled anesthetics can cause immunosuppression and inflammation; propofol demonstrates a protective effect.
- Opioids may potentially enhance cancer recurrence and metastasis.
- Local anesthetics inhibit cancer cell proliferation and migration while inducing apoptosis in vitro and in vivo.
Conclusions:
- Anesthesiologists should prioritize pain and stress reduction strategies.
- Regional anesthesia and multimodal analgesia, including anti-inflammatory drugs, are crucial for perioperative pain management.
- These approaches may improve recurrence-free survival in cancer patients.
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