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Propofol (TIVA) Versus Volatile-Based Anesthetics: Is There Any Oncological Benefit?

  • Cancer Anesthesia (B Riedel and V Gottumukkala, Section Editors)
  • Published:
Current Anesthesiology Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

To summarize the most recent available clinical and pre-clinical research data concerning the effects of propofol-based total intravenous anesthesia (TIVA) and volatile anesthesia on oncological outcomes and to discuss the biological basis by which these drugs are purported to exert effects on the cancer cell and on the host.

Recent Findings

Recent retrospective analyses of clinical datasets have generated considerable interest in the hypothesis that the two major classes of general anesthetics in clinical use for oncological surgery—namely inhalational fluranes and intravenous propofol—disparately influence post-operative cancer outcomes. There is also growing pre-clinical data to indicate that these drugs exert distinct effects on cancer cell and immune cell phenotypes.

Summary

The available evidence tends to support the superiority of propofol in terms of the effect on oncological outcomes, but there is a lack of prospective data and a need to be mindful of the complexity and heterogeneity of both the perioperative period and cancer as a disease when interpreting study results and deciding future directions.

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Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Authors and Affiliations

  1. Signalling & Cancer Metabolism Team, Division of Cancer Biology, The Institute of Cancer Research, 237 Fulham Road, London, SW3 6JB, UK

    Nicholas J. S. Perry

  2. Department of Anaesthetics & Critical Care, The Royal Marsden NHS Foundation Trust, Fulham Road, London, SW3 6JJ, UK

    Timothy Wigmore

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Nicholas J.S. Perry and Timothy Wigmore declare they have no conflict of interest.

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This article is part of the Topical Collection on Cancer Anesthesia

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Perry, N.J.S., Wigmore, T. Propofol (TIVA) Versus Volatile-Based Anesthetics: Is There Any Oncological Benefit?. Curr Anesthesiol Rep 8, 399–410 (2018). https://doi.org/10.1007/s40140-018-0296-z

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