Attenuation of the Tumor-promoting Effect of Surgery by Spinal Blockade in Rats

Abstract

The addition of spinal blockade to general halothane anesthesia markedly attenuates the promotion of metastasis by surgery.

Regional anesthesia and prostate cancer recurrence

“…Thus, as might be expected, spinal anesthesia helps preserve natural killer cell function and reduces metastatic load to the lungs, 7 and non-opioid analgesia helps preserve natural killer cell function and reduces metastatic spread of cancer in rodents. 8,9 Finally, three retrospective clinical studies are consistent with this theory.…”

“…• Surgery releases tumour cells into the circulation [1][2][3] ; depresses cell-mediated immunity, including cytotoxic T-cell and natural killer cell functions [7][8][9][10] ; reduces circulating concentrations of tumour-related anti-angiogenic factors, e.g., angiostatin and endostatin [11][12][13][14] ; increases concentrations of pro-angiogenic factors, such as vascular endothelial growth factor 15,16 ; and releases growth factors that promote local and distant growth of malignant tissue. 5 • Anesthesia impairs immune functions, including neutrophil, macrophages, dendritic cells, T-cell, and NKcell functions.…”

“…• La chirurgie libère des cellules tumorales dans la circulation [1][2][3] ; elle déprime l'immunité médiée par les cellules, y compris les fonctions des lymphocytes T cytotoxiques et des cellules tueuses naturelles [7][8][9][10] ; elle réduit les concentrations en circulation de facteurs anti-angiogéniques liés à la tumeur, par ex. l'angiotensine et l'endostatine [11][12][13][14] ; elle augmente les concentrations de facteurs pro-angiogéniques, tels que le facteur de croissance endothélial 15,16 ; et elle libère les facteurs de croissance qui favorisent la croissance locale et distante de tissus malins.…”

“…Dès lors, comme on peut s'y attendre, la rachianesthésie aide à conserver la fonction des cellules tueuses naturelles et réduit la charge métastatique aux poumons, 7 alors que l'analgésie non opioïde aide à conserver la fonction des cellules tueuses naturelles et réduit la propagation métastatique du cancer chez le rongeur. 8,9 Enfin, trois études cliniques rétrospectives soutiennent cette théorie.…”

Perioperative management and oncological outcomes following radical cystectomy for bladder cancer: a matched retrospective cohort study

“…It is important to preserve the function of natural killer (NK) cells, a subset of lymphocytes that spontaneously recognize and kill tumour cells. 2,3 Several perioperative factors may impair immunologic defenses. Specifically, surgical manipulation disseminates malignant cells into the bloodstream, 4 surgical stress promotes metastatic growth by affecting immunosuppression through neuroendocrine pathways, 2,3 and the use of systemic opioids directly inhibits NK cell activity.…”