How Anesthetic, Analgesic and Other Non-Surgical Techniques During Cancer Surgery Might Affect Postoperative Oncologic Outcomes: A Summary of Current State of Evidence

Abstract

The question of whether anesthetic, analgesic or other perioperative intervention during cancer resection surgery might influence long-term oncologic outcomes has generated much attention over the past 13 years. A wealth of experimental and observational clinical data have been published, but the results of prospective, randomized clinical trials are awaited. The European Union supports a pan-European network of researchers, clinicians and industry partners engaged in this question (COST Action 15204: Euro-Periscope). In this narrative review, members of the Euro-Periscope network briefly summarize the current state of evidence pertaining to the potential effects of the most commonly deployed anesthetic and analgesic techniques and other non-surgical interventions during cancer resection surgery on tumor recurrence or metastasis.

Comparison of Biochemical Recurrence After Robot-assisted Laparoscopic Radical Prostatectomy with Volatile and Total Intravenous Anesthesia

“…The nervous system is a primary actor in early and late cancer development. Many cancers (e.g., colon and prostate) present a specific growth pattern called "perineural invasion" which is driven by neurons [32]. The growth of some cancers, such as prostate cancer, pancreatic cancer, and breast cancer, is associated with "neurogenesis" and abundant infiltration of the tumor by the autonomic nervous system [33].…”

Comparison of two pain postoperative treatment methods in patients with rectal carcinoma

“…adding local anesthetic to analgesia via an intra-wound catheter or local neural blocks seem to have a systemic anti-inflammatory effect. Lidocaine derivates stabilize the cell membrane, which not only reduces the pain notion but also probably reduces inflammation and cell migration (9).…”

Breast cancer and the black swan

“…We propose that exploring the perioperative window will be a good place to start this process [80,81]. Other relevant papers have been published [82][83][84][85][86][87][88][89][90][91][92][93][94][95][96][97][98][99].…”