Anesthesia in patients with cancer disorders

Kurosawa, Shin

doi:10.1097/aco.0b013e328352b4a8

Cited by 75 publications

(73 citation statements)

References 108 publications

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“…[4] As allogeneic blood transfusion modulates the host immune system, it may also influence cancer recurrence. [77] As transfused leucocytes potentially alter circulating lymphocyte ratios and function, irradiated or leucocyte-depleted red-cells are frequently preferentially administered to oncology patients.…”

Section: Interaction Between the Immune System And Cancer Cellsmentioning

confidence: 99%

“…[1] Anaesthetists are increasingly faced with the challenge of managing cancer patients, either for surgical resection to debulk or excise the primary tumour, the mainstay of treatment in many forms of cancer (particularly solid tumours), or for the analgesic management of disease-or treatment-related chronic pain in a proportion of the increasing number of people living with or overcoming cancer, concurrent with improvements in oncological therapies. [2][3][4] Metastatic recurrence is a concern and occurs commonly. While the pattern of tumour growth is usually non-linear, with periods of dormancy alternating with periods of growth [5][6][7][8], surgery potentially alters this pattern.…”

mentioning

confidence: 99%

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Does regional anaesthesia and analgesia or opioid analgesia influence recurrence after primary cancer surgery? An update of available evidence

Ash

Buggy

2013

Best Practice & Research Clinical Anaesthesiology

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Cancer continues to be a key cause of morbidity and mortality worldwide and its overall incidence continues to increase. Anaesthetists are increasingly faced with the challenge of managing cancer patients, either for surgical resection to debulk or excise the primary tumour, surgical emergencies in patients on chemotherapy, or for the analgesic management of disease-or treatmentrelated chronic pain. Metastatic recurrence is a concern. Surgery and a number of perioperative factors are suspected to accelerate tumour growth and potentially increase the risk of metastatic recurrence. Retrospective analyses have suggested an association between anaesthetic technique and cancer outcomes, and anaesthetists have sought to ameliorate the consequences of surgical trauma and minimize the impact of anaesthetic interventions. Just how anaesthesia and analgesia impact cancer recurrence and consequent survival is very topical, as understanding the potential mechanisms and interactions impacts on the anaesthetist's ability to contribute to the successful outcome of oncological interventions . 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 ABSTRACT Cancer continues to be a key cause of morbidity and mortality worldwide and its overall incidence continues to increase. Anaesthetists are increasingly faced with the challenge of managing cancer patients, either for surgical resection to debulk or excise the primary tumour, surgical emergencies in patients on chemotherapy, or for the analgesic management of disease-or treatment-related chronic pain. Metastatic recurrence is a concern. Surgery and a number of perioperative factors are suspected to accelerate tumour growth and potentially increase the risk of metastatic recurrence. Retrospective analyses have suggested an association between anaesthetic technique and cancer outcomes, and anaesthetists have sought to ameliorate the consequences of surgical trauma and minimize the impact of anaesthetic interventions. Just how anaesthesia and analgesia impact cancer recurrence and consequent survival is very topical, as understanding the potential mechanisms and interactions impacts on the anaesthetist"s ability to contribute to the successful outcome of oncological interventions.

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Section: Interaction Between the Immune System And Cancer Cellsmentioning

confidence: 99%

mentioning

confidence: 99%

Does regional anaesthesia and analgesia or opioid analgesia influence recurrence after primary cancer surgery? An update of available evidence

Ash

Buggy

2013

Best Practice & Research Clinical Anaesthesiology

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“…Activation by morphine has been shown to have a negative effect on neutrophil function, an effect also not seen with fentanyl. 34 A possible link is provided by the observation that the peripheral mu receptor antagonist methylnaltrexone inhibits morphine VEGF-induced angiogenesis and reduces human breast, colorectal, and non-small cell lung tumour growth in vitro. 34 Clinically relevant doses of morphine have been shown to promote tumour neovascularisation and increased tumour progression in a human breast tumour xenograft mouse model.…”

Section: Opioidsmentioning

confidence: 99%

Impact of anesthesia for cancer surgery: Continuing Professional Development

Green

Tsui

2013

Can J Anesth/J Can Anesth

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“…On the other hand, cancer proliferation involves several stimuli and mediators, which can be all affected by the anesthetics [147,152].…”

Section: Does the Type Of Anesthesia Influence The Risk Of Cancer Recmentioning

confidence: 99%

“…Regional anesthesia is believed to be beneficial against cancer recurrence due to reduced exposure to immunosuppressive agents (i.e., nitrous oxide), reduced surgical stress and adrenergic stimulation, but the mechanism is still unclear [147]. In fact, in absence of surgical stress, both general and local anesthesia have minor and transient effects on immune function [151].On the other hand, cancer proliferation involves several stimuli and mediators, which can be all affected by the anesthetics [147,152].NK cells activity was investigated in patients undergoing laparotomy colectomy under either general anesthesia or epidural anesthesia alone [145]. Patients receiving general anesthesia had a significant reduction of NK cells activity (36% vs. 22%, p=0.02) respect to preoperative values, whereas the epidural group did not shown significant changes.…”

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confidence: 99%

Anesthesia, cytokines and cancer recurrence

Kitamura¹,

Biaso²,

Ingelmo

et al. 2015

Glob Anesth Perioper Med

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Cytokines are essential mediators for the regulation of both innate and acquired immunity and hematopoiesis. They modulate immune cell signaling, activation, adhesion and functioning. They regulate the individual response to several insults such as infection, inflammation, trauma, and pain. Moreover, the balance between pro-inflammatory and anti-inflammatory cytokines is critical for the evolution of surgical complications and tumor progression.Several drugs, including anesthetic agents, influence cytokines secretion. Opioids, inhalational agents, intravenous and local anesthetics have shown different effects on immune system and cytokine expression. Therefore, anesthesia may play an important role in postoperative recovery and outcome of cancer patients.The aim of the present article is to review the main role of some important cytokines and the effect of anesthesia techniques and drugs on their secretion. Furthermore, current clinical evidence regarding the effects of anesthesia on cancer recurrence will be discussed. Cytokines and immune systemCytokines are proteins expressed in both innate and acquired immune system and are often named according to the secreting cells (i.e., lymphocytes, interleukins, etc.). They are essential mediators of the natural (non-specific, innate) immunity, which is the initial step of the inflammatory response. They also play a pivotal role during the specific immunity, which occurs after exposure to antigens, as they regulate lymphocyte and leukocyte activation, growth and differentiation, and the immune-mediated inflammation [1].The cytokines have different structures, but also common aspects, which are summarized in Table 1.The aim of the present article is to review the main role of some important cytokines and the effect of anesthesia techniques and drugs on their secretion. Cytokines receptorsThe cytokines receptors are formed by one or more transmembrane proteins: the extracellular portion binds the cytokine, whereas the cytoplasmic part starts the signal cascade. Based on the extracellular portion, they are divided in five categories. 1) Type I receptors, which have four α-helical stands and contain four cysteine residues and the amino acid motif tryptophanserine-X-tryptophan-serine (WSXWS).2) Type II receptors, structurally similar to Type I receptors, but without the sequence WSXWS. Cytokines functionProvided that the same cytokine may be produced during both innate and acquired immunity response, cytokines can be classified according to their functions: 1)Cytokines regulating the innate immunity and secreted by stimulated macrophages; 2)Cytokines regulating the acquired immunity and secreted by lymphocytes; 3)Cytokines stimulating the hematopoiesiss and secreted by bone marrow, leucocytes and other cells. Common aspects of CytokineTheir secretion is brief and limited in time Cytokine expressed during the innate immunity response Tumor necrosis factor (TNF-α, TNF-β)The TNF is responsible for the initial phase of acute inflammatory response, especially against ...

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Anesthesia in patients with cancer disorders

Cited by 75 publications

References 108 publications

Does regional anaesthesia and analgesia or opioid analgesia influence recurrence after primary cancer surgery? An update of available evidence

Does regional anaesthesia and analgesia or opioid analgesia influence recurrence after primary cancer surgery? An update of available evidence

Impact of anesthesia for cancer surgery: Continuing Professional Development

Anesthesia, cytokines and cancer recurrence

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