Perioperative Inflammatory Response and Cancer Recurrence in Lung Cancer Surgery: A Narrative Review

Abstract

While surgical resection is the gold standard treatment for solid tumors, cancer recurrence after surgery is common. Immunosurveillance of remnant tumor cells is an important protective mechanism. Therefore, maintenance of anti-tumor cell activity and proper levels of inflammatory mediators is crucial. An increasing body of evidence suggests that surgery itself and perioperative interventions could affect these pathophysiological responses. Various factors, such as the extent of tissue injury, perioperative medications such as anesthetics and analgesics, and perioperative management including transfusions and methods of mechanical ventilation, modulate the inflammatory response in lung cancer surgery. This narrative review summarizes the pathophysiological mechanisms involved in cancer recurrence after surgery and perioperative management related to cancer recurrence after lung cancer surgery.

Exhaled breath analysis in patients with potentially curative lung cancer undergoing surgery: a longitudinal study

“…It is remarkable that all patients in the lower left cluster had developed a recurrent or secondary lung cancer in the meantime, which remained undetected in the initial diagnostic and surgical procedures. Patients might already had have secondary undetected lung cancer during the measurements, recurring cancer following surgical resection, or tumor cells spread through the peripheral blood as circulating tumor cells and therefore might still be detected in exhaled breath [34]. The pattern noticed in the upper sub-group and the outlier in the lower right corner could be linked to methodological factors, as they were all assessed during the same month.…”

Perioperative oncolytic virotherapy to counteract surgery-induced immunosuppression and improve outcomes in pancreatic ductal adenocarcinoma

“…The physical act of surgical excision instigates a stress response that provokes a surge in cortisol and catecholamines by the sympathetic nervous system (SNS), leading to the activation of physiological mechanisms such as the inflammatory response and angiogenesis that aids in tissue and wound healing. However, angiogenesis and inflammation have also been linked to the survival of residual tumor cells, metastasis, and recurrence of cancer ( 44 , 45 ). Surgery related risk factors, including duration of surgery, extent of tissue damage, blood loss, hypothermia, and the administration of blood products have all been shown to contribute towards postoperative immunosuppression ( 14 , 33 , 45 – 49 ).…”

A Photothermal Therapy Study Based on Electrospinning Nanofibers Blended and Coated with Polydopamine Nanoparticles

“…Unfortunately, cancer recurrence and metastasis still occur from time to time. [1][2][3] Photothermal therapy has emerged and attracted tremendous interest as a promising nanotherapeutic option for cancer therapy owing to its effectiveness and noninvasiveness. In particular, photothermal nanoagents triggered by near-infrared light (NIR) are preferred for the photothermal treatment of cancer.…”

“…Even surgery, radiation, chemotherapy, or interventional therapy can be very effective for early‐stage cancer patients. Unfortunately, cancer recurrence and metastasis still occur from time to time [1–3] . Photothermal therapy has emerged and attracted tremendous interest as a promising nanotherapeutic option for cancer therapy owing to its effectiveness and non‐invasiveness.…”