title: Regional anaesthesia and cancer metastases: the implication of local anaesthetics.
abstract: Clinical and basic science studies have demonstrated the anti-inflammatory properties of local anaesthetics. Recent studies have begun to unravel molecular pathways linking inflammation and cancer. Regional anaesthesia is associated in some retrospective clinical studies with reduced risk of metastasis and increased long-term survival. The potential beneficial effects of regional anaesthesia have been attributed mainly to the inhibition of the neuroendocrine stress response to surgery and to the reduction in the requirements of volatile anaesthetics and opioids. Because cancer is linked to inflammation and local anaesthetics have anti-inflammatory effects, these agents may participate in reducing the risk of metastasis, but their mechanism of action is unknown. We demonstrated in vitro that amide local anaesthetics attenuate tumour cell migration as well as signalling pathways enhancing tumour growth and metastasis. This has provided the first evidence of a molecular mechanism by which regional anaesthesia might inhibit or reduce cancer metastases.
authors.affiliation: Department of Anaesthesiology, University of Illinois at Chicago, Chicago, IL, USA; Jesse Brown VA Medical Center, University of Illinois at Chicago, Chicago, IL, USA.
authors.forename: E G
authors.initials: EG
authors.lastname: Votta-Velis
authors.forename: T
authors.initials: T
authors.lastname: Piegeler
authors.forename: R D
authors.initials: RD
authors.lastname: Minshall
authors.forename: J
authors.initials: J
authors.lastname: Aguirre
authors.forename: B
authors.initials: B
authors.lastname: Beck-Schimmer
authors.forename: D E
authors.initials: DE
authors.lastname: Schwartz
authors.forename: A
authors.initials: A
authors.lastname: Borgeat
mesh_terms: D055371:Acute Lung Injury / Q000188:drug therapy; D000765:Anesthesia, Conduction; D000779:Anesthetics, Local / Q000494:pharmacology*; D000818:Animals; D000893:Anti-Inflammatory Agents / Q000494:pharmacology; D006801:Humans; D007249:Inflammation / Q000150:complications; D016328:NF-kappa B / Q000502:physiology; D009362:Neoplasm Metastasis / Q000517:prevention & control*; D009360:Neoplastic Cells, Circulating
chemical_list: D000779:Anesthetics, Local; D000893:Anti-Inflammatory Agents; D016328:NF-kappa B