title: Can anesthetic techniques or drugs affect cancer recurrence in patients undergoing cancer surgery?
abstract: Despite the development of effective chemotherapy and radiotherapy, surgery remains the mainstay treatment of many cancers, requiring anesthesia. Almost all cancer deaths after primary surgery are attributable to recurrence or metastases. Recently it has been hypothesized that the perioperative anesthetic management of cancer patients could potentially affect the risk of recurrence and metastases, which implies a key role for anesthesiologists in choosing anesthetic agents and techniques that optimize the balance between the metastatic potential of the tumor versus its elimination by antimetastatic immune defenses. This review summarizes available experimental information on the potential effects of common anesthetic agents and techniques on cancer metastases and the conflicting retrospective clinical data on regional anesthesia in various types of cancer. A number of prospective, randomized, multicenter, clinical trials are in progress, and their results are eagerly awaited.
authors.affiliation: Department of Anesthesiology, Hirosaki University Graduate School of Medicine, Aomori, Japan.
authors.forename: Hidetomo
authors.initials: H
authors.lastname: Niwa
authors.forename: David J
authors.initials: DJ
authors.lastname: Rowbotham
authors.forename: David G
authors.initials: DG
authors.lastname: Lambert
authors.forename: Donal J
authors.initials: DJ
authors.lastname: Buggy
mesh_terms: D000758:Anesthesia / Q000009:adverse effects*; D000777:Anesthetics / Q000009:adverse effects*; D002986:Clinical Trials as Topic; D006801:Humans; D015337:Multicenter Studies as Topic; D009364:Neoplasm Recurrence, Local / Q000209:etiology*; D009369:Neoplasms / Q000601:surgery*; D011446:Prospective Studies; D016032:Randomized Controlled Trials as Topic; D012189:Retrospective Studies
chemical_list: D000777:Anesthetics