Journal of Anesthesia

, Volume 27, Issue 5, pp 731–741

Can anesthetic techniques or drugs affect cancer recurrence in patients undergoing cancer surgery?

  • Hidetomo Niwa
  • David J. Rowbotham
  • David G. Lambert
  • Donal J. Buggy
Invited Review Article

DOI: 10.1007/s00540-013-1615-7

Cite this article as:
Niwa, H., Rowbotham, D.J., Lambert, D.G. et al. J Anesth (2013) 27: 731. doi:10.1007/s00540-013-1615-7

Abstract

Despite the development of effective chemotherapy and radiotherapy, surgery remains the mainstay treatment of many cancers, requiring anesthesia. Almost all cancer deaths after primary surgery are attributable to recurrence or metastases. Recently it has been hypothesized that the perioperative anesthetic management of cancer patients could potentially affect the risk of recurrence and metastases, which implies a key role for anesthesiologists in choosing anesthetic agents and techniques that optimize the balance between the metastatic potential of the tumor versus its elimination by antimetastatic immune defenses. This review summarizes available experimental information on the potential effects of common anesthetic agents and techniques on cancer metastases and the conflicting retrospective clinical data on regional anesthesia in various types of cancer. A number of prospective, randomized, multicenter, clinical trials are in progress, and their results are eagerly awaited.

Keywords

Anesthetic drugs and techniquesGeneral and regional anesthesiaCancer recurrenceMetastases

Copyright information

© Japanese Society of Anesthesiologists 2013

Authors and Affiliations

  • Hidetomo Niwa
    • 1
  • David J. Rowbotham
    • 2
  • David G. Lambert
    • 3
  • Donal J. Buggy
    • 4
    • 5
  1. 1.Department of AnesthesiologyHirosaki University Graduate School of MedicineAomoriJapan
  2. 2.Department of Health Sciences, University of Leicester, Division of AnaesthesiaCritical Care and Pain Management, Leicester Royal InfirmaryLeicesterUK
  3. 3.Department of Cardiovascular Sciences, University of Leicester, Division of AnaesthesiaCritical Care and Pain Management, Leicester Royal InfirmaryLeicesterUK
  4. 4.Division of Anaesthesia, Intensive Care and Pain MedicineMater Misericordiae University Hospital and National Cancer Screening Service Eccles UnitDublinIreland
  5. 5.Outcomes Research Consortium, Cleveland ClinicClevelandUSA