An oncological surgical resection is the mainstay of treatment for potentially curable colon cancer. At the time of surgery, a large fraction of patients do harbour-although not visibly-minimal residual disease at the time of surgery. The immunosuppression that accompanies surgery may have an effect on disease recurrence and survival. Regional or neuraxial anaesthetic techniques like epidural anaesthesia may suppress immune function less than opioid analgesia, by reducing stress response and significantly reducing exposure to opioids. Consistent with this hypothesis, regional anaesthetic techniques have been associated with lower recurrence rates in breast cancer and prostate cancer. Results for colon cancer, however, are contradictory. In this review of the literature we describe all studies addressing the association of the use of epidural anaesthesia and survival in colon cancer surgery.
Keywords: colon cancer; epidural anaesthesia; immunosuppression; survival.
© The Author(s) 2015. Published by Oxford University Press and the Digestive Science Publishing Co. Limited.