title: Perioperative propofol-paravertebral anesthesia decreases the metastasis and progression of breast cancer.
abstract: Propofol-paravertebral anesthesia (PPA) is a unique combination of paravertebral nerve blocks (PVBs) and propofol that regulates the cellular microenvironment during surgical period. Growing evidence points to its ability to attenuate perioperative immunosuppression of cancers. Abundant studies show that cancer patients who undergo perioperative PPA exhibit less recurrence as well as metastasis. Breast cancer remains a leading cause of cancer-induced death in women. Over the last decades, increasing concerns have been put on the promotional role of PPA in the prognosis of breast cancer patients. Among them, PPA participates in several bioprocesses in the development of breast cancer, including inhibiting hypoxia-inducible factor (HIF) activity, elevating serum concentration of nitric oxide index (NOx), depression of the neuroepithelial cell transforming gene 1 (NET1) signal pathway, blocking the nuclear factor kappa B (NF-κB) pathway following an decreased expression of matrix metalloproteinase (MMP), increasing NK cytotoxicity, and affecting transforming growth factor (TGF)-β-targeted ras and HER2/neu gene pathways. In this review, we discuss the effect of PPA on breast cancer metastasis and progression. This will provide an alteration pattern of surgical anesthesia technique in breast cancer patients with poor prognosis.
authors.affiliation: The Fourth Clinical School of Nanjing Medical University, Baiziting 42, Nanjing, 210009, China.|Department of General Surgery, Jiangsu Cancer Hospital Affiliated to Nanjing Medical University, Baiziting 42, Nanjing, 210009, China.
authors.forename: Xiu
authors.initials: X
authors.lastname: Chen
authors.affiliation: School of Public Healthy Nanjing Medical University, Jiangsulu 172, Nanjing, 210009, China.
authors.forename: Peng
authors.initials: P
authors.lastname: Lu
authors.affiliation: Department of Oncology, Xuzhou Medical College, Xuzhou, 221004, China.
authors.forename: Lin
authors.initials: L
authors.lastname: Chen
authors.affiliation: The Fourth Clinical School of Nanjing Medical University, Baiziting 42, Nanjing, 210009, China.|Department of General Surgery, Jiangsu Cancer Hospital Affiliated to Nanjing Medical University, Baiziting 42, Nanjing, 210009, China.
authors.forename: Su-jin
authors.initials: SJ
authors.lastname: Yang
authors.affiliation: The Fourth Clinical School of Nanjing Medical University, Baiziting 42, Nanjing, 210009, China.|Department of General Surgery, Jiangsu Cancer Hospital Affiliated to Nanjing Medical University, Baiziting 42, Nanjing, 210009, China.
authors.forename: Hong-Yu
authors.initials: HY
authors.lastname: Shen
authors.affiliation: Department of General Surgery, Jiangsu Cancer Hospital Affiliated to Nanjing Medical University, Baiziting 42, Nanjing, 210009, China.
authors.forename: Dan-dan
authors.initials: DD
authors.lastname: Yu
authors.affiliation: Center of Clinical Laboratory Science, Jiangsu Cancer Hospital Affiliated to Nanjing Medical University, Baiziting 42, Nanjing, 210009, China.
authors.forename: Xiao-hui
authors.initials: XH
authors.lastname: Zhang
authors.affiliation: Center of Clinical Laboratory Science, Jiangsu Cancer Hospital Affiliated to Nanjing Medical University, Baiziting 42, Nanjing, 210009, China.
authors.forename: Shan-liang
authors.initials: SL
authors.lastname: Zhong
authors.affiliation: Center of Clinical Laboratory Science, Jiangsu Cancer Hospital Affiliated to Nanjing Medical University, Baiziting 42, Nanjing, 210009, China. jsccljhzhao@126.com.
authors.forename: Jian-hua
authors.initials: JH
authors.lastname: Zhao
authors.affiliation: Department of General Surgery, Jiangsu Cancer Hospital Affiliated to Nanjing Medical University, Baiziting 42, Nanjing, 210009, China. jschjhtang@163.com.
authors.forename: Jin-hai
authors.initials: JH
authors.lastname: Tang
mesh_terms: D000758:Anesthesia; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy* / Q000473:pathology; D009407:Nerve Block; D059035:Perioperative Period; D011379:Prognosis; D015742:Propofol / Q000627:therapeutic use*
chemical_list: D015742:Propofol
keywords: Breast cancer; Paravertebral anesthesia; Prognosis; Propofol