Anesthetic technique and cancer outcomes: a meta-analysis of total intravenous versus volatile anesthesia

Yap, Andrea; López-Olivo, María A.; Dubowitz, Julia; Hiller, Jonathan G.; Riedel, Bernhard

doi:10.1007/s12630-019-01330-x

Cited by 184 publications

(150 citation statements)

References 49 publications

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“…8 Notably, a meta-analysis study including 7866 patients with different types of cancer discovered that the use of propofol improved the OS and RFS of cancer in comparison with the use of inhalational anaesthesia. 9 Additionally, another retrospective cohort study found that propofol anaesthesia was related to better OS and a lower postoperative biochemical recurrence rate than those with desflurane anaesthesia in patients undergoing robot-assisted radical prostatectomy. 85 However, these previous studies have the limitations of most retrospective investigations.…”

Section: Effec T Of Prop Ofol On the Prog Nos Is Of Patients With Cmentioning

confidence: 99%

Effects of propofol on the development of cancer in humans

Pan

Jiang

et al. 2020

Cell Proliferation

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Cancer is one of most the significant threats to human health worldwide, and the primary method of treating solid tumours is surgery. Propofol, one of the most widely used intravenous anaesthetics in surgery, was found to be involved in many cancer‐related pathophysiology processes, mainly including anti‐tumour and minor cancer‐promoting effects in various types of cancer. An increasing number of studies have identified that propofol plays a role in cancer by regulating the expression of multiple signalling pathways, downstream molecules, microRNAs and long non‐coding RNAs. Emerging evidence has indicated that propofol can enhance the anti‐tumour effect of chemotherapeutic drugs or some small molecular compounds. Additionally, in vivo animal models have shown that propofol inhibits tumour growth and metastasis. Furthermore, most clinical trials indicate that propofol is associated with better survival outcomes in cancer patients after surgery. Propofol use is encouraged in cancers that appear to have a better prognosis after its use during surgery. We hope that future large and prospective multicenter studies will provide more precise answers to guide the choice of anaesthetics during cancer surgery.

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Section: Effec T Of Prop Ofol On the Prog Nos Is Of Patients With Cmentioning

confidence: 99%

Effects of propofol on the development of cancer in humans

Pan

Jiang

et al. 2020

Cell Proliferation

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“…58 Another systematic review and meta-analysis, very recently published by Yap et al examine the potential effects of anesthetic strategies for cancer surgery on survival. 59 Compared to volatile anesthesia, total intravenous anesthesia was characterized by lower mortality in patients with gastric . 59 The explanation of these findings might be searched into the effects of single drugs on immune system components.…”

Section: Current Evidence On the Effects Of Anesthesia On Short And Lmentioning

confidence: 99%

“…59 Compared to volatile anesthesia, total intravenous anesthesia was characterized by lower mortality in patients with gastric . 59 The explanation of these findings might be searched into the effects of single drugs on immune system components.…”

Section: Current Evidence On the Effects Of Anesthesia On Short And Lmentioning

confidence: 99%

<p>Anesthetic Strategies in Oncological Surgery: Not Only a Simple Sleep, but Also Impact on Immunosuppression and Cancer Recurrence</p>

Longhini¹,

Bruni²,

Garofalo³

et al. 2020

CMAR

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Tumor recurrences or metastases remain a major hurdle in improving overall cancer survival. In the perioperative period, the balance between the ability of the cancer to seed and grow at the metastatic site and the ability of the patient to fight against the tumor (i.e. the host antitumor immunity) may determine the development of clinically evident metastases and influence the patient outcome. Up to 80% of oncological patients receive anesthesia and/or analgesia for diagnostic, therapeutic or palliative interventions. Therefore, anesthesiologists are asked to administer drugs such as opiates and volatile or intravenous anesthetics, which may determine different effects on immunomodulation and cancer recurrence. For instance, some studies suggest that intravenous drugs, such as propofol, may inhibit the host immunity to a lower extent as compared to volatile anesthetics. Similarly, some studies suggest that analgesia assured by local anesthetics may provide a reduction of cancer recurrence rate; whilst on the opposite side, opioids may exert negative consequences in patients undergoing cancer surgery, by interacting with the immune system response via the modulation of the hypothalamic-pituitary-adrenal axis and autonomic nervous system, or directly through the opioid receptors on the surface of immune cells. In this review, we summarize the main findings on the effects induced by different drugs on immunomodulation and cancer recurrence.

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“…ont analysé les données probantes les plus récentes portant sur la question de savoir si le type d'anesthésie influençait la récurrence du cancer et la survie. 8 Leur méta-analyse s'est concentrée sur les médicaments utilisés pour le maintien de l'anesthésie générale -soit une anesthésie intraveineuse totale (TIVA) au propofol, ou des agents anesthésiques volatils par inhalation. Les travaux de Yap et coll.…”

Section: Les Anesthésiologistes Peuvent-ils Avoir Un Impact Sur Les Punclassified

“…In this issue of the Journal, Yap et al analyzed the most current evidence looking at whether the type of anesthesia delivered influences cancer recurrence and survival. 8 Their metaanalysis focused on the medication used for maintenance of general anesthesia-i.e., total intravenous anesthesia (TIVA) with propofol compared with volatile inhaled anesthetic agents. Yap et al report ten studies (nine retrospective observational trials and one small randomized-controlled trial) that looked at recurrencefree survival and overall survival after cancer surgery.…”

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confidence: 99%