Effect of anaesthetic technique on the natural killer cell anti-tumour activity of serum from women undergoing breast cancer surgery: a pilot study

Abstract

NCT 041857.

Do Amide Local Anesthetics Play a Therapeutic Role in the Perioperative Management of Cancer Patients?

“…26 In contrast, a very recent study showed that lidocaine at clinically relevant concentrations of 0.01 and 0.1 mM was able to enhance NK cytolytic activity in vitro through the release of lytic granules. 27 Similar results were obtained from a pilot study of patients undergoing breast cancer resection, who had either received a regional anesthetic (paravertebral block) in combination with propofol-based total intravenous anesthesia or intravenous opioids together with a sevoflurane general anesthetic; serum from women randomized to the regional/total intravenous anesthesia group induced a greater cytolytic activity in NK cells from healthy donors than serum from women who had been administered opioids and sevoflurane, 28 indicating a possible beneficial effect of regional anesthesia and local anesthetics with respect to NK cell activity in patients undergoing (breast) cancer surgery.…”

Comparing the Effects of Combined General/Epidural Anaesthesia and General Anaesthesia on Serum Cytokine Levels in Radical Cystectomy

“…Anestezinin cerrahiden bağımsız olarak nötrofil, makrofaj, natural killer (NK) hücreleri ve dendritik hücrelerin fonksiyonlarını bozarak anjiyogenezi, enerji metabolizması, hücre proliferasyonu, apoptozis ve hücre migrasyonunu etkilediği bilinmektedir (16). İnhalasyon ajanları adrenerjik aktiviteyi ve hücre içi kalsiyum konsantrasyonunu, sitokin üretimini ve postoperatif dönemde immün modülasyonu etkilerler (14).…”

Can anesthetic-analgesic technique during primary cancer surgery affect recurrence or metastasis?

“…36 A recent translational study conducted on a subset of patients enrolled in an ongoing multicentre RCT in breast cancer patients found that the serum of women (n = 10) with breast cancer randomized to receive propofol-paravertebral anesthesia for excisional surgery preserved NK immune cell cytotoxicity and breast cancer cell apoptosis to a greater extent than the serum of women randomized to receive standard volatile-based general anesthesia with opioid analgesia. 37 Practitioners may choose to promote regional anesthesia with propofol-based general anesthesia to their cancer patients for many reasons other than the possibility of an effect on cancer recurrence. The continuing prospective RCT (ClinicalTrials.gov number, NCT00418457) may prove to address whether this technique has a cause and effect link to cancer recurrence.…”