Abstract
A wealth of basic science data supports the hypothesis that the surgical stress response increases the likelihood of cancer dissemination and metastasis during and after cancer surgery. Anesthetic management of the cancer patient, therefore, could potentially influence long-term outcome. Preclinical data suggest that beneficial approaches might include selection of induction drugs such as propofol, minimizing the use of volatile anesthetics, and coadministration of cyclooxygenase antagonists with systemic opioids. Retrospective clinical trials suggest that the addition of regional anesthesia might decrease recurrence after cancer surgery. Other factors such as blood transfusion, temperature regulation, and statin administration may also affect long-term outcome.
MeSH terms
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Adrenergic alpha-Agonists / adverse effects
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Adrenergic alpha-Agonists / therapeutic use
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Adrenergic beta-Antagonists / adverse effects
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Adrenergic beta-Antagonists / therapeutic use
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Analgesics, Opioid / adverse effects
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Analgesics, Opioid / therapeutic use
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Anemia / complications
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Anemia / etiology
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Anesthesia*
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Anesthesia, Conduction
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Anesthetics / adverse effects
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Anesthetics / therapeutic use
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Anesthetics, Inhalation / adverse effects
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Anesthetics, Inhalation / therapeutic use
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Blood Transfusion
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Cyclooxygenase Inhibitors / adverse effects
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Cyclooxygenase Inhibitors / therapeutic use
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Humans
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Hydroxymethylglutaryl-CoA Reductase Inhibitors / adverse effects
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Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use
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Hypothermia, Induced
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Neoplasm Metastasis / prevention & control
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Neoplasm Recurrence, Local / epidemiology*
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Neoplasms / epidemiology*
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Neoplasms / immunology
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Neoplasms / surgery*
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Perioperative Care*
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Stress, Physiological
Substances
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Adrenergic alpha-Agonists
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Adrenergic beta-Antagonists
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Analgesics, Opioid
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Anesthetics
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Anesthetics, Inhalation
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Cyclooxygenase Inhibitors
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Hydroxymethylglutaryl-CoA Reductase Inhibitors