Influence of Perioperative Anesthesia on Cancer Recurrence: from Basic Science to Clinical Practice

Curr Oncol Rep. 2023 Feb;25(2):63-81. doi: 10.1007/s11912-022-01342-9. Epub 2022 Dec 13.

Abstract

Purposeof review: In this review, we will summarize the effects of these perioperative anesthetics and anesthetic interventions on the immune system and tumorigenesis as well as address the related clinical evidence on cancer-related mortality and recurrence.

Recent findings: Cancer remains a leading cause of morbidity and mortality worldwide. For many solid tumors, surgery is one of the major therapies. Unfortunately, surgery promotes angiogenesis, shedding of circulating cancer cells, and suppresses immunity. Hence, the perioperative period has a close relationship with cancer metastases or recurrence. In the perioperative period, patients require multiple anesthetic management including anesthetics, anesthetic techniques, and body temperature control. Preclinical and retrospective studies have found that these anesthetic agents and interventions have complex effects on cancer outcomes. Therefore, well-planned, prospective, randomized controlled trials are required to explore the effects of different anesthetics and techniques on long-term outcomes after cancer surgery. Due to the conflicting effects of anesthetic management on cancer recurrence, further preclinical and clinical trials are required and beneficial to the development of systemic cancer therapies.

Keywords: Anesthesia; Cancer recurrence; Immune system; Perioperative period; Surgery.

Publication types

  • Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anesthesia* / adverse effects
  • Anesthesia* / methods
  • Anesthetics* / therapeutic use
  • Humans
  • Neoplasm Recurrence, Local / pathology
  • Neoplasm Recurrence, Local / prevention & control
  • Prospective Studies
  • Retrospective Studies

Substances

  • Anesthetics