Review article: the role of the perioperative period in recurrence after cancer surgery.
A wealth of basic science data supports the hypothesis that the surgical stress response increases the likelihood of cancer dissemination and metastasis during and after cancer surgery. Anesthetic management of the cancer patient, therefore, could potentially influence long-term outcome. Preclinical data suggest that beneficial approaches might include selection of induction drugs such as propofol, minimizing the use of volatile anesthetics, and coadministration of cyclooxygenase antagonists with systemic opioids. Retrospective clinical trials suggest that the addition of regional anesthesia might decrease recurrence after cancer surgery. Other factors such as blood transfusion, temperature regulation, and statin administration may also affect long-term outcome.
Gottschalk
Antje
A
Department of Anesthesiology, University of Virginia, Charlottesville, VA, USA.
Sharma
Sonal
S
Ford
Justin
J
Durieux
Marcel E
ME
Tiouririne
Mohamed
M
D000316:Adrenergic alpha-Agonists / Q000009:adverse effects / Q000627:therapeutic use; D000319:Adrenergic beta-Antagonists / Q000009:adverse effects / Q000627:therapeutic use; D000701:Analgesics, Opioid / Q000009:adverse effects / Q000627:therapeutic use; D000740:Anemia / Q000150:complications / Q000209:etiology; D000758:Anesthesia; D000765:Anesthesia, Conduction; D000777:Anesthetics / Q000009:adverse effects / Q000627:therapeutic use; D018685:Anesthetics, Inhalation / Q000009:adverse effects / Q000627:therapeutic use; D001803:Blood Transfusion; D016861:Cyclooxygenase Inhibitors / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000009:adverse effects / Q000627:therapeutic use; D007036:Hypothermia, Induced; D009362:Neoplasm Metastasis / Q000517:prevention & control; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology*; D009369:Neoplasms / Q000453:epidemiology* / Q000276:immunology / Q000601:surgery*; D019990:Perioperative Care; D013312:Stress, Physiological
D000316:Adrenergic alpha-Agonists; D000319:Adrenergic beta-Antagonists; D000701:Analgesics, Opioid; D000777:Anesthetics; D018685:Anesthetics, Inhalation; D016861:Cyclooxygenase Inhibitors; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors