Impact of anesthesia choice in cutaneous melanoma surgery

Benesch, Matthew G.K.; Skitzki, Joseph J.

doi:10.1097/cmr.0000000000000936

Cited by 2 publications

(1 citation statement)

References 74 publications

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“…Unlike cytotoxic CD8 + T cells, NK cells respond rapidly to targets with heightened cytotoxicity, yet they have lower immunogenicity and may not need additional ligand-driven activation. Hence, there is growing recognition of the potential significance of NK-cell-based therapy in the development of future immunotherapies [146]. Volatiles inhibit the cytotoxicity of NK cells and can trigger apoptosis in T-lymphocytes that drive immune surveillance and anti-metastatic immunity following cancer surgery.…”

Section: Inhalational Anesthesiamentioning

confidence: 99%

Perioperative Immunosuppressive Factors during Cancer Surgery: An Updated Review

Bezu,

Akçal Öksüz,

Bell

et al. 2024

Cancers

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Surgical excision of the primary tumor represents the most frequent and curative procedure for solid malignancies. Compelling evidence suggests that, despite its beneficial effects, surgery may impair immunosurveillance by triggering an immunosuppressive inflammatory stress response and favor recurrence by stimulating minimal residual disease. In addition, many factors interfere with the immune effectors before and after cancer procedures, such as malnutrition, anemia, or subsequent transfusion. Thus, the perioperative period plays a key role in determining oncological outcomes and represents a short phase to circumvent anesthetic and surgical deleterious factors by supporting the immune system through the use of synergistic pharmacological and non-pharmacological approaches. In line with this, accumulating studies indicate that anesthetic agents could drive both protumor or antitumor signaling pathways during or after cancer surgery. While preclinical investigations focusing on anesthetics’ impact on the behavior of cancer cells are quite convincing, limited clinical trials studying the consequences on survival and recurrences remain inconclusive. Herein, we highlight the main factors occurring during the perioperative period of cancer surgery and their potential impact on immunomodulation and cancer progression. We also discuss patient management prior to and during surgery, taking into consideration the latest advances in the literature.

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Section: Inhalational Anesthesiamentioning

confidence: 99%

Perioperative Immunosuppressive Factors during Cancer Surgery: An Updated Review

Bezu,

Akçal Öksüz,

Bell

et al. 2024

Cancers

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Can General Anesthesia Facilitate the Detection of Clinically Significant Prostate Cancer in Prostate Fusion Biopsy?

Yakut

2024

Andrologia

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Background. Although the use of anesthetics in prostate biopsy on pain has been well studied, its effect on the diagnosis of clinically significant prostate cancer (csCPa) is not well known. We aimed to investigate the contribution of performing the prostate fusion biopsy (PFB) procedure under general anesthesia (GA) to diagnosing csCPa. Materials and Methods. We retrospectively analyzed the data of 252 patients who underwent multiparametric magnetic resonance imaging (MpMRI)—guided PFB. Patients were divided into two groups: those under local anesthesia (LA) and GA. For LA and GA groups, csCPa capture rates in PFB were evaluated separately and in total for Prostate Imaging Reporting and Data System (PIRADS) 3, PIRADS 4, and PIRADS 5 lesions. It was investigated whether the PFB application under GA increases the chance of csCPa capture. Chi‐square and z‐ratio analysis was performed to determine the change in pathological diagnosis according to the anesthesia method. Results. A total of 411 lesions were detected by MpMRI in 252 men included in the study. LA was applied to 61.5% and GA to 38.5% of the patients. We found that the type of anesthesia affected the frequency of csCPa detection only for anterior lesions. Clinically insignificant prostate cancer (CIPC) was detected more frequently in the GA group than in the LA group. Considering PIRADS 3, PIRADS 4, and all lesion groups, benign pathology was statistically significantly more frequent in the LA group, while CIPC was statistically significantly more frequent in the GA group (p = 0.000). Conclusion. Our study showed that performing PFB under GA may contribute to the diagnosis of csCPa in anterior region lesions. However, this effect could not be demonstrated when all lesions were examined. In fact, it causes more CIPCs to be caught. Considering that the CIPC approach is contradictory in the literature; multicenter, prospective studies with large participation are needed, taking into account patient and lesion characteristics.

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Impact of anesthesia choice in cutaneous melanoma surgery

Cited by 2 publications

References 74 publications

Perioperative Immunosuppressive Factors during Cancer Surgery: An Updated Review

Perioperative Immunosuppressive Factors during Cancer Surgery: An Updated Review

Can General Anesthesia Facilitate the Detection of Clinically Significant Prostate Cancer in Prostate Fusion Biopsy?

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