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Anesthetics or anesthetic techniques and cancer surgical outcomes: a possible link

대한마취과학회지 2021년 74권 3호 p.191 ~ 203
Alam Azeem, Rampes Sanketh, Patel Sonam, Hana Zac, Ma Daqing,
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 ( Alam Azeem ) - Imperial College London Faculty of Medicine Department of Surgery
 ( Rampes Sanketh ) - Imperial College London Faculty of Medicine Department of Surgery
 ( Patel Sonam ) - Imperial College London Faculty of Medicine Department of Surgery
 ( Hana Zac ) - Imperial College London Faculty of Medicine Department of Surgery
 ( Ma Daqing ) - Imperial College London Faculty of Medicine Department of Surgery

Abstract


As of 2018 cancer is responsible for almost 9.6 million deaths annually and, with an aging population, the incidence of cancer is expected to continue to rise. Surgery is an important treatment modality for patients with solid organ cancers. It has been postulated that, due to potentially overlapping processes underlying the development of malignancy and the therapeutic pathways of various anesthetic agents, the choice of anesthetic type and method of administration may affect post-operative outcomes in patients with cancer. This is a literature review of the most recent evidence extracted from various databases including PubMed, EMBASE, and the Cochrane, as well as journals and book reference lists. The review highlights the pathophysiological processes underpinning cancer development and the molecular actions of anesthetic agents, pre-clinical and retrospective studies investigating cancer and anesthetics, as well as ongoing clinical trials. Overall, there are conflicting results regarding the impact of regional vs. general anesthesia on cancer recurrence, whilst the majority of data suggest a benefit of the use of intravenous propofol over inhalational volatile anesthetics. The biological changes associated with the surgical inflammatory response offer a unique opportunity to intervene to counteract any potentially cancer-promoting effects.

키워드

Anesthesia; Anesthetics; Cancer; Neoplasms; Postoperative period; Surgery

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