Anesthetic Techniques and Cancer Recurrence

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Sasima Dusitkasem


Cancer is a major cause of morbidity and mortality around the world. Surgical resection is the mainstay of treatment of solid tumor. Perioperative factors affect cancer cells and host’s immunity, which contribute to promote the development of metastasis such as suppression of cell-mediated immunity especially NK cell activity. Data from laboratory and animal experiments suggests that anesthesia and anesthetics may significantly contribute immunosuppression and raises a valid concern regarding the potential role of anesthetic and analgesic techniques in causing cancer recurrence and metastases. Regional anesthesia attenuates the neuroendocrine stress response, reducing opioid, and intraoperative volatile anesthetic agent requirements. Recent observational studies have found a strong association between the use of regional anesthesia for cancer surgery and reductions in late recurrence of cancer. However, these findings must be interpreted cautiously as the majority of studies are in vitro, animal models and retrospective studies. Anesthesiologists should choose anesthetic techniques that minimize the impact of perioperative deleterious immune cell changes, reduce the inflammatory and adrenergic surgical stress response and focus on rapid return of functional recovery.

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Review articles


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