Tumor Biology

, Volume 36, Issue 11, pp 8259–8266 | Cite as

Perioperative propofol-paravertebral anesthesia decreases the metastasis and progression of breast cancer

  • Xiu Chen
  • Peng Lu
  • Lin Chen
  • Su-jin Yang
  • Hong-Yu Shen
  • Dan-dan Yu
  • Xiao-hui Zhang
  • Shan-liang Zhong
  • Jian-hua ZhaoEmail author
  • Jin-hai TangEmail author


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.


Propofol Paravertebral anesthesia Breast cancer Prognosis 



Propofol-paravertebral anesthesia


Hypoxia-inducible factor-1α


Nitric oxide synthase


Chronic postsurgical pain




Neuroepithelial Cell Transforming Gene 1


Ras homolog gene family member A


Inhibitor of nuclear factor kappa B kinase


Matrix metalloproteinases


Vascular endothelial growth factor


Epithelial to mesenchymal transition




Sine oculis homeobox homolog 1


Transforming growth factor


Mitogen-activated protein kinase


Phosphatidylinositol 3-kinase



This work has no fund. We thank Shan-Liang Zhong, M.D. for his discussion and help in the revision.

Conflicts of interest



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Copyright information

© International Society of Oncology and BioMarkers (ISOBM) 2015

Authors and Affiliations

  • Xiu Chen
    • 1
    • 4
  • Peng Lu
    • 2
  • Lin Chen
    • 3
  • Su-jin Yang
    • 1
    • 4
  • Hong-Yu Shen
    • 1
    • 4
  • Dan-dan Yu
    • 4
  • Xiao-hui Zhang
    • 5
  • Shan-liang Zhong
    • 5
  • Jian-hua Zhao
    • 5
    Email author
  • Jin-hai Tang
    • 4
    Email author
  1. 1.The Fourth Clinical School of Nanjing Medical UniversityNanjingChina
  2. 2.School of Public Healthy Nanjing Medical UniversityNanjingChina
  3. 3.Department of OncologyXuzhou Medical CollegeXuzhouChina
  4. 4.Department of General SurgeryJiangsu Cancer Hospital Affiliated to Nanjing Medical UniversityNanjingChina
  5. 5.Center of Clinical Laboratory ScienceJiangsu Cancer Hospital Affiliated to Nanjing Medical UniversityNanjingChina

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