Perspectives in anaesthesia for cancer surgery.
BACKGROUND
It is a fact that inflammatory scores are important prognostic factors in cancer surgery. Many data have been published last year showing that inflammation is a causative event in many cancers and a concomitant event in all malignant tumours. MONITORING OF THE INFLAMMATION: What is new is that we can assess inflammatory status during the preoperative period of our cancer patients with simple and widely available parameters, such as the neutrophil/lymphocyte ratio. This kind of biomarkers will be helpful, for the clinicians, to stratify the patients and, for the researcher, to incorporate it in clinical trials. RATIONALE FOR TRIALS AFTER DATABASE ANALYSES: Promising clinical trials, focusing on perioperative inflammation, are ongoing. Rationale for these trials came from database analyses. This kind of analyses must be extended to follow the long-term effects of our interventions. NON-STEROIDAL ANTI-INFLAMMATORY DRUGS: We have shown a correlation between non-steroidal anti-inflammatory drugs, especially ketorolac, and improved outcome (metastasis-free survival and/or overall survival) in breast and lung cancer patients.


CONCLUSIONS
Focusing on a high-risk group with preoperative inflammation could lead to a clinical trial to test the effect of ketorolac on cancer outcome.
Patrice
P
Forget
Marc
M
De Kock
D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D015415:Biomarkers / Q000097:blood; D001943:Breast Neoplasms / Q000097:blood / Q000601:surgery*; D002986:Clinical Trials as Topic; D005260:Female; D006801:Humans; D007249:Inflammation / Q000188:drug therapy* / Q000473:pathology; D020910:Ketorolac / Q000627:therapeutic use*; D008175:Lung Neoplasms / Q000097:blood / Q000601:surgery*; D008214:Lymphocytes; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control; D009504:Neutrophils; D059035:Perioperative Period
D000894:Anti-Inflammatory Agents, Non-Steroidal; D015415:Biomarkers; D020910:Ketorolac