Surgery for Cancer: A Trigger for Metastases.

Area of Science:

• Oncology
• Surgical Oncology
• Cancer Biology

Background:

• Surgery is a critical cancer treatment offering curative potential.
• The perioperative period presents risks for micrometastatic disease progression and new metastasis formation.
• The precise impact of surgery on cancer recurrence remains incompletely understood.

Purpose of the Study:

• To review clinical and experimental evidence linking surgery and inflammation to cancer recurrence.
• To explore how surgical trauma and perioperative factors influence metastatic processes.
• To suggest novel therapeutic strategies targeting the perioperative window for improved oncological outcomes.

Main Methods:

• Systematic review of existing clinical and experimental literature.
• Analysis of mechanisms by which surgery promotes cancer cell shedding, immune suppression, and metastasis.
• Examination of the role of inflammation and perioperative factors (anesthesia, transfusions, hypothermia, complications) in disease recurrence.

Main Results:

• Surgery increases cancer cell shedding and suppresses anti-tumor immunity.
• Surgical trauma triggers inflammatory responses that can accelerate micrometastatic growth.
• Perioperative factors like anesthesia and hypothermia may also contribute to early recurrence.

Conclusions:

• Surgery can create a protumorigenic environment, increasing the risk of cancer recurrence.
• Targeting the inflammatory and immune-modulating effects of surgery is a potential therapeutic avenue.
• Further research is needed to develop strategies that mitigate perioperative risks and improve long-term cancer survival.