Innate immune function after breast, lung, and colorectal cancer surgery

Ramirez, María F.; Ai, Di; Bauer, Maria; Vauthey, Jean Nicolas; Gottumukkala, Vijaya; Kee, Spencer Stephen; Shon, Daliah; Truty, Mark J.; Kuerer, Henry Mark; Kurz, Anrea; Hernandez, Mike; Cata, Juan P.

doi:10.1016/j.jss.2014.10.030

Cited by 37 publications

(28 citation statements)

References 33 publications

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“…The main findings of these studies were an antiapoptotic effect mediated by the serum of women who received sevoflurane/opioid GA and inhibition of cell proliferation after the exposure to serum of women who had PVB/propofol GA. 23,25 Women who receive general volatile anesthesia show a significant decrease in the count and function of NK cells. 28,29 Therefore, it has been hypothesized that regional anesthesia could ameliorate the suppressive effect that surgery per se, volatile anesthetics, and opioids have on those cells. Two RCTs have demonstrated that women who underwent mastectomies and were treated with PVB/ propofol GA showed not only a better preservation of in vitro NK cell function but also a higher intensity of CD56 + cells in the tumor microenviroment in comparison to women who had GA with sevoflurane and opioids.…”

Section: Discussionmentioning

confidence: 99%

Impact of Regional Anesthesia on Recurrence, Metastasis, and Immune Response in Breast Cancer Surgery

Pérez-González

Cuéllar-Guzmán

Soliz

et al. 2017

Regional Anesthesia and Pain Medicine

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Section: Discussionmentioning

confidence: 99%

Impact of Regional Anesthesia on Recurrence, Metastasis, and Immune Response in Breast Cancer Surgery

Pérez-González

Cuéllar-Guzmán

Soliz

et al. 2017

Regional Anesthesia and Pain Medicine

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“…Surgery has been described to cause NK cell dysfunction, 50 but these effects were of limited duration, with cytotoxic capacity returning to pre-surgery values after approximately 30 d 47 . In our cohort of STS patients, blood samples were taken at least 4 weeks after surgery.…”

Section: Discussionmentioning

confidence: 99%

Progressive natural killer cell dysfunction associated with alterations in subset proportions and receptor expression in soft-tissue sarcoma patients

et al. 2016

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Immunotherapy is currently investigated as treatment option in many types of cancer. So far, results from clinical trials have demonstrated that significant benefit from immunomodulatory therapies is restricted to patients with select histologies. To broaden the potential use of these therapies, a deeper understanding for mechanisms of immunosuppression in patients with cancer is needed. Soft-tissue sarcoma (STS) presents a medical challenge with significant mortality even after multimodal treatment. We investigated function and immunophenotype of peripheral natural killer (NK) cells from chemotherapy-naive STS patients (1st line) and STS patients with progression or relapse after previous chemotherapeutic treatment (2nd line). We found NK cells from peripheral blood of both STS patient cohorts to be dysfunctional, being unable to lyse K562 target cells while NK cells from renal cell cancer (RCC) patients did not display attenuated lytic activity. Ex vivo stimulation of NK cells from STS patients with interleukin-2 plus TKD restored cytotoxic function. Furthermore, altered NK cell subset composition with reduced proportions of CD56dim cells could be demonstrated, increasing from 1st- to 2nd-line patients. 2nd-line patients additionally displayed significantly reduced expression of receptors (NKG2D), mediators (CD3ζ), and effectors (perforin) of NK cell activation. In these patients, we also detected fewer NK cells with CD57 expression, a marker for terminally differentiated cytotoxic NK cells. Our results elucidate mechanisms of NK cell dysfunction in STS patients with advanced disease. Markers like NKG2D, CD3ζ, and perforin are candidates to characterize NK cells with effective antitumor function for immunotherapeutic interventions.

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“…Median follow-up times were recorded at 5.8-6 yrs., and Cata et al (2016) identified that the use of fentanyl was lower in the PVB group ( , 2005) identified that the type of anesthesia given had any impact on concentrations of GF growth factor in the postoperative period. Two studies identified women who received GA showed significant decrease in NK cell function and count (Ramirez et al, 2015;Woo et al, 2015). Perez-Gonzalez et al (2017) concluded that regional anesthesia could amend the suppressive effects of surgery on human cells from avoiding harmful volatile anesthetics and opioids.…”

Section: Resultsmentioning

confidence: 99%

“…the post-operative period were studied. Results showed no impact on concentrations in relation to anesthesia technique used (Looney et al, 2010;O'Riain et al, 2005) • Two studies identified women who received GA. A significant decrease in NK cell function and count were noted (Ramirez et al, 2015;Woo et al, 2015). These authors hypothesized that regional anesthesia could amend the suppressive effect of surgery, and effect on human cells from volatile anesthetic impact and opioids.…”

Section: Retrospective Studymentioning

confidence: 99%

Anesthetic Use and Cancer Recurrence in the Surgical Oncological Patient: An Integrative Review

Hauser¹

2018

Preprint

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This integrative review compared anesthetic usage and its impact on the cancer patient.Immunosuppression from anesthesia can have major impacts on the human body's immune system and lead to a decrease in overall patient survival and an increase in cancer recurrence rates. A search was completed using electronic databases including CINAHL, PubMed Health, and Medline Plus. The studies were located with keyword searches and inclusion and exclusion criteria was used to locate a final 8 studies for the review. A critical appraisal was completed using Polit and Beck's critical analysis tables, displaying key characteristics of the studies chosen. Outcomes reviewed included overall survival rates, cancer recurrence rates, time to recurrence and biomarker identification.The findings presented more beneficial outcomes with regional anesthesia, but larger prospective randomized studies are needed to validate these findings. Regional anesthesia has shown to increase time to recurrence, decrease recurrence rates, and limit the increase in immune biomarkers. However, regional anesthesia does not fully support an increase in overall survival rates. More research and randomized control trials are warranted on this topic. Overall, this integrative review has supported the use of regional anesthesia for more positive outcomes in the oncological surgical patient over general anesthesia. Anesthetics and Cancer Recurrence in the Surgical Oncological Patient:An Integrative Review of the Literature Background/Statement of the ProblemAn estimated 234 million surgeries are undertaken every year world-wide (Weiser et al., 2008) and of this 234 million, an estimated 20% are related to cancer (Hoekstra et al., 2015). Cancer is a global epidemic, being the leading and most common cause of death worldwide (Torre et al., 2015). This is amplified by the increasing age and growth of our population. The rise in cancer cases is strongly associated with an increase in sedentary lifestyles, poor diets and smoking (Torre et al., 2015). The word 'cancer' constitutes immediate negative connotations for valid reasons. Each year in the United States over 1 million cases of individuals diagnosed with cancer are recorded (Le-Wendling, Nin, & Capdevila, 2015). In 2012, 14 million new cancer cases were documented, and 8.2 million cancer deaths occurred globally (Torre et al., 2015). An additional 1.6 million cases were diagnosed in 2016 and of these cases an estimated 33% will die from the developed disease (Bharati, Chowdhury, Bergese, & Ghosh, 2016). These staggering figures provide us with a clear picture of why cancer remains one the leading causes of mortality in the world. Increased risk factors for cancer developmentThreatened populations. Certain populations are at greater risk for cancer development, such as men and the elderly. The incidence in North America of cancer in men versus (vs.) women was 344:295 out of 100,000 (Torre et al., 2015). The cancer mortality rate per 100,000 of men vs. women was 123:91 (Torre et al., 2015). The underlying re...

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Innate immune function after breast, lung, and colorectal cancer surgery

Cited by 37 publications

References 33 publications

Impact of Regional Anesthesia on Recurrence, Metastasis, and Immune Response in Breast Cancer Surgery

Impact of Regional Anesthesia on Recurrence, Metastasis, and Immune Response in Breast Cancer Surgery

Progressive natural killer cell dysfunction associated with alterations in subset proportions and receptor expression in soft-tissue sarcoma patients

Anesthetic Use and Cancer Recurrence in the Surgical Oncological Patient: An Integrative Review

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