Anesthetic Techniques and Cancer Recurrence
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Published:
Sep 28, 2018
Keywords:
general anesthesia cancer recurrence immune system
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Abstract
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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References
1.Tracey KJ. Reflex control of immunity. Nat Rev Immunol 2009;9(6):418-28.
2. Wada H, Seki S, Takahashi T, Kawarabayashi N, et al. Combined spinal and general anesthesia attenuates liver metastasis by preserving TH1/TH2 cytokine balance. Anesthesiology 2007;106(3):499-506.
3. Thaker PH, Han LY, Kamat AA, Arevalo JM, et al. Chronic stress promotes tumor growth and angiogenesis in a mouse model of ovarian carcinoma. Nat Med 2006;12(8):939-44.
4. Heaney A, Buggy DJ. Can anaesthetic and analgesic techniques affect cancer recurrence or metastasis? Br J Anaesth 2012;109 Suppl 1:i17-i28.
5. Snyder GL, Greenberg S. Effect of anaesthetic technique and other perioperative factors on cancer recurrence. Br J Anaesth 2010;105(2):106-15.
6. Benzonana LL, Perry NJ, Watts HR, et al. Isoflurane, a commonly used volatile anesthetic, enhances renal cancer growth and malignant potential via the hypoxia-inducible factor cellular signaling pathway in vitro. Anesthesiology 2013;119(3):593-605.
7. Muller-Edenborn B, Roth-Z’graggen B, Bartnicka K, et al. Volatile anesthetics reduce invasion of colorectal cancer cells through down-regulation of matrix metalloproteinase-9. Anesthesiology 2012;117(2):293-301.
8. Fleischmann E, Marschalek C, Schlemitz K, et al. Nitrous oxide may not increase the risk of cancer recurrence after colorectal surgery: a follow-up of a randomized controlled trial. BMC Anesthesiol 2009;9:1.
9. Green JS, Tsui BC. Impact of anesthesia for cancer surgery: Continuing professional development. Can J Anaesth 2013;60(12):1248-69.
10. Melamed R, Bar-Yosef S, Shakhar G, Shakhar K, Ben-Eliyahu S. Suppression of natural killer cell activity and promotion of tumor metastasis by ketamine, thiopental, and halothane, but not by propofol: mediating mechanisms and prophylactic measures. Anesth Analg 2003;97(5):1331-9.
11. Inada T, Kubo K, Shingu K. Possible link between cyclooxygenase-inhibiting and antitumor properties of propofol. J Anesth 2011;25(4):569-75.
12. Kushida A, Inada T, Shingu K. Enhancement of antitumor immunity after propofol treatment in mice. Immunopharmacol Immunotoxicol 2007;29(3-4):477-86.
13. Ohta N, Ohashi Y, Fujino Y. Ketamine inhibits maturation of bone marrow-derived dendritic cells and priming of the Th1-type immune response. Anesth Analg 2009;109(3):793- 800.
14. Forget P, Collet V, Lavand’homme P, De Kock M. Does analgesia and condition influence immunity after surgery? Effects of fentanyl, ketamine and clonidine on natural killer activity at different ages. Eur J Anaesthesiol 2010;27(3):233-40.
15. Beilin B, Rusabrov Y, Shapira Y, et al. Low-dose ketamine affects immune responses in humans during the early postoperative period. Br J Anaesth 2007;99(4):522-7.
16. Singleton PA, Moss J, Karp DD, Atkins JT, Janku F. The mu opioid receptor: A new target for cancer therapy? Cancer 2015;121(16):2681-8.
17. Mathew B, Lennon FE, Siegler J, et al. The novel role of the mu opioid receptor in lung cancer progression: a laboratory investigation. Anesth Analg 2011;112(3):558-67.
18. Kraus J. Regulation of mu-opioid receptors by cytokines. Frontiers in bioscience (Scholar edition) 2009;1:164-70.
19. Franchi S, Moretti S, Castelli M, et al. Mu opioid receptor activation modulates Toll like receptor 4 in murine macrophages. Brain Behav Immun 2012;26(3):480-8.
20. Hatsukari I, Hitosugi N, Ohno R, et al. Induction of apoptosis by morphine in human tumor cell lines in vitro. Anticancer Res 2007;27(2):857-64.
21. Byrne K, Levins KJ, Buggy DJ. Can anesthetic-analgesic technique during primary cancer surgery affect recurrence or metastasis? Can J Anaesth 2016;63(2):184-92.
22. Lucchinetti E, Awad AE, Rahman M, et al. Antiproliferative effects of local anesthetics on mesenchymal stem cells: potential implications for tumor spreading and wound healing. Anesthesiology 2012;116(4):841-56.
23. Lirk P, Berger R, Hollmann MW, Fiegl H. Lidocaine time- and dose-dependently demethylates deoxyribonucleic acid in breast cancer cell lines in vitro. Br J Anaesth 2012;109(2):200-7.
24. Harris RE. Cyclooxygenase-2 (cox-2) blockade in the chemoprevention of cancers of the colon, breast, prostate, and lung. Inflammopharmacology 2009;17(2):55-67.
25. Forget P, De Kock M. Perspectives in anaesthesia for cancer surgery J Cancer Res Clin Oncol 2014;140(3):353-9.
26. Retsky M, Rogers R, Demicheli R, et al. NSAID analgesic ketorolac used perioperatively may suppress early breast cancer relapse: particular relevance to triple negative subgroup. Breast Cancer Res Treat 2012;134(2):881-8.
27. Forget P, Vandenhende J, Berliere M, et al. Do intraoperative analgesics influence breast cancer recurrence after mastectomy? A retrospective analysis. Anesth Analg 2010; 110(6):1630-5.
28. Afsharimani B, Cabot P, Parat MO. Morphine and tumor growth and metastasis. Cancer Metastasis Rev 2011;30(2): 225-38.
29. Meserve JR, Kaye AD, Prabhakar A, Urman RD. The role of analgesics in cancer propagation. Best Pract Res Clin Anaesthesiol 2014;28(2):139-51.
30. Exadaktylos AK, Buggy DJ, Moriarty DC, Mascha E, Sessler DI. Can anesthetic technique for primary breast cancer surgery affect recurrence or metastasis? Anesthesiology 2006;105(4):660-4.
31. Tedore T. Regional anaesthesia and analgesia: relationship to cancer recurrence and survival. Br J Anaesth 2015;115 Suppl 2:ii34-ii45.
32. Biki B, Mascha E, Moriarty DC, Fitzpatrick JM, Sessler DI, Buggy DJ. Anesthetic technique for radical prostatectomy surgery affects cancer recurrence: a retrospective analysis. Anesthesiology 2008;109(2):180-7.
33. Myles PS, Peyton P, Silbert B, Hunt J, Rigg JR, Sessler DI. Perioperative epidural analgesia for major abdominal surgery for cancer and recurrence-free survival: randomised trial. BMJ (Clinical research ed) 2011;342:d1491.
34. Christopherson R, James KE, Tableman M, Marshall P, Johnson FE. Long-term survival after colon cancer surgery: a variation associated with choice of anesthesia. Anesth Analg 2008;107(1):325-32.
35. Cummings KC 3rd, Xu F, Cummings LC, Cooper GS. A comparison of epidural analgesia and traditional pain management effects on survival and cancer recurrence after colectomy: a population-based study. Anesthesiology 2012;116(4):797-806.
36. Gupta A, Björnsson A, Fredriksson M, Hallböök O, Eintrei C. Reduction in mortality after epidural anaesthesia and analgesia in patients undergoing rectal but not colonic can¬cer surgery: a retrospective analysis of data from 655 pa¬tients in central Sweden. Br J Anaesth 2011;107(2):164-70.
37. Holler JP, Ahlbrandt J, Burkhardt E, et al. Peridural analgesia may affect long-term survival in patients with colorectal cancer after surgery
(PACO-RAS-Study): an analysis of a cancer registry. Ann Surg 2013;258(6):989-93.
2. Wada H, Seki S, Takahashi T, Kawarabayashi N, et al. Combined spinal and general anesthesia attenuates liver metastasis by preserving TH1/TH2 cytokine balance. Anesthesiology 2007;106(3):499-506.
3. Thaker PH, Han LY, Kamat AA, Arevalo JM, et al. Chronic stress promotes tumor growth and angiogenesis in a mouse model of ovarian carcinoma. Nat Med 2006;12(8):939-44.
4. Heaney A, Buggy DJ. Can anaesthetic and analgesic techniques affect cancer recurrence or metastasis? Br J Anaesth 2012;109 Suppl 1:i17-i28.
5. Snyder GL, Greenberg S. Effect of anaesthetic technique and other perioperative factors on cancer recurrence. Br J Anaesth 2010;105(2):106-15.
6. Benzonana LL, Perry NJ, Watts HR, et al. Isoflurane, a commonly used volatile anesthetic, enhances renal cancer growth and malignant potential via the hypoxia-inducible factor cellular signaling pathway in vitro. Anesthesiology 2013;119(3):593-605.
7. Muller-Edenborn B, Roth-Z’graggen B, Bartnicka K, et al. Volatile anesthetics reduce invasion of colorectal cancer cells through down-regulation of matrix metalloproteinase-9. Anesthesiology 2012;117(2):293-301.
8. Fleischmann E, Marschalek C, Schlemitz K, et al. Nitrous oxide may not increase the risk of cancer recurrence after colorectal surgery: a follow-up of a randomized controlled trial. BMC Anesthesiol 2009;9:1.
9. Green JS, Tsui BC. Impact of anesthesia for cancer surgery: Continuing professional development. Can J Anaesth 2013;60(12):1248-69.
10. Melamed R, Bar-Yosef S, Shakhar G, Shakhar K, Ben-Eliyahu S. Suppression of natural killer cell activity and promotion of tumor metastasis by ketamine, thiopental, and halothane, but not by propofol: mediating mechanisms and prophylactic measures. Anesth Analg 2003;97(5):1331-9.
11. Inada T, Kubo K, Shingu K. Possible link between cyclooxygenase-inhibiting and antitumor properties of propofol. J Anesth 2011;25(4):569-75.
12. Kushida A, Inada T, Shingu K. Enhancement of antitumor immunity after propofol treatment in mice. Immunopharmacol Immunotoxicol 2007;29(3-4):477-86.
13. Ohta N, Ohashi Y, Fujino Y. Ketamine inhibits maturation of bone marrow-derived dendritic cells and priming of the Th1-type immune response. Anesth Analg 2009;109(3):793- 800.
14. Forget P, Collet V, Lavand’homme P, De Kock M. Does analgesia and condition influence immunity after surgery? Effects of fentanyl, ketamine and clonidine on natural killer activity at different ages. Eur J Anaesthesiol 2010;27(3):233-40.
15. Beilin B, Rusabrov Y, Shapira Y, et al. Low-dose ketamine affects immune responses in humans during the early postoperative period. Br J Anaesth 2007;99(4):522-7.
16. Singleton PA, Moss J, Karp DD, Atkins JT, Janku F. The mu opioid receptor: A new target for cancer therapy? Cancer 2015;121(16):2681-8.
17. Mathew B, Lennon FE, Siegler J, et al. The novel role of the mu opioid receptor in lung cancer progression: a laboratory investigation. Anesth Analg 2011;112(3):558-67.
18. Kraus J. Regulation of mu-opioid receptors by cytokines. Frontiers in bioscience (Scholar edition) 2009;1:164-70.
19. Franchi S, Moretti S, Castelli M, et al. Mu opioid receptor activation modulates Toll like receptor 4 in murine macrophages. Brain Behav Immun 2012;26(3):480-8.
20. Hatsukari I, Hitosugi N, Ohno R, et al. Induction of apoptosis by morphine in human tumor cell lines in vitro. Anticancer Res 2007;27(2):857-64.
21. Byrne K, Levins KJ, Buggy DJ. Can anesthetic-analgesic technique during primary cancer surgery affect recurrence or metastasis? Can J Anaesth 2016;63(2):184-92.
22. Lucchinetti E, Awad AE, Rahman M, et al. Antiproliferative effects of local anesthetics on mesenchymal stem cells: potential implications for tumor spreading and wound healing. Anesthesiology 2012;116(4):841-56.
23. Lirk P, Berger R, Hollmann MW, Fiegl H. Lidocaine time- and dose-dependently demethylates deoxyribonucleic acid in breast cancer cell lines in vitro. Br J Anaesth 2012;109(2):200-7.
24. Harris RE. Cyclooxygenase-2 (cox-2) blockade in the chemoprevention of cancers of the colon, breast, prostate, and lung. Inflammopharmacology 2009;17(2):55-67.
25. Forget P, De Kock M. Perspectives in anaesthesia for cancer surgery J Cancer Res Clin Oncol 2014;140(3):353-9.
26. Retsky M, Rogers R, Demicheli R, et al. NSAID analgesic ketorolac used perioperatively may suppress early breast cancer relapse: particular relevance to triple negative subgroup. Breast Cancer Res Treat 2012;134(2):881-8.
27. Forget P, Vandenhende J, Berliere M, et al. Do intraoperative analgesics influence breast cancer recurrence after mastectomy? A retrospective analysis. Anesth Analg 2010; 110(6):1630-5.
28. Afsharimani B, Cabot P, Parat MO. Morphine and tumor growth and metastasis. Cancer Metastasis Rev 2011;30(2): 225-38.
29. Meserve JR, Kaye AD, Prabhakar A, Urman RD. The role of analgesics in cancer propagation. Best Pract Res Clin Anaesthesiol 2014;28(2):139-51.
30. Exadaktylos AK, Buggy DJ, Moriarty DC, Mascha E, Sessler DI. Can anesthetic technique for primary breast cancer surgery affect recurrence or metastasis? Anesthesiology 2006;105(4):660-4.
31. Tedore T. Regional anaesthesia and analgesia: relationship to cancer recurrence and survival. Br J Anaesth 2015;115 Suppl 2:ii34-ii45.
32. Biki B, Mascha E, Moriarty DC, Fitzpatrick JM, Sessler DI, Buggy DJ. Anesthetic technique for radical prostatectomy surgery affects cancer recurrence: a retrospective analysis. Anesthesiology 2008;109(2):180-7.
33. Myles PS, Peyton P, Silbert B, Hunt J, Rigg JR, Sessler DI. Perioperative epidural analgesia for major abdominal surgery for cancer and recurrence-free survival: randomised trial. BMJ (Clinical research ed) 2011;342:d1491.
34. Christopherson R, James KE, Tableman M, Marshall P, Johnson FE. Long-term survival after colon cancer surgery: a variation associated with choice of anesthesia. Anesth Analg 2008;107(1):325-32.
35. Cummings KC 3rd, Xu F, Cummings LC, Cooper GS. A comparison of epidural analgesia and traditional pain management effects on survival and cancer recurrence after colectomy: a population-based study. Anesthesiology 2012;116(4):797-806.
36. Gupta A, Björnsson A, Fredriksson M, Hallböök O, Eintrei C. Reduction in mortality after epidural anaesthesia and analgesia in patients undergoing rectal but not colonic can¬cer surgery: a retrospective analysis of data from 655 pa¬tients in central Sweden. Br J Anaesth 2011;107(2):164-70.
37. Holler JP, Ahlbrandt J, Burkhardt E, et al. Peridural analgesia may affect long-term survival in patients with colorectal cancer after surgery
(PACO-RAS-Study): an analysis of a cancer registry. Ann Surg 2013;258(6):989-93.