The Effects of Anesthetics on Recurrence and Metastasis of Cancer, and Clinical Implications

Abstract

Surgical resection of the primary tumor may enhance the metastasis and recurrence of cancer. The reaction of patients to surgery includes changes of the immune system, the inflammatory system and the neuroendocrine system. In the perioperative period, anesthetics are used both for anesthesia and analgesia. There are several studies showing that the progression of cancer can be influenced by many kinds of anesthetics, although most of these studies are preclinical and thus have not yet influenced clinical recommendations. This review summarizes recent studies regarding the effects of anesthetics on metastasis and recurrence of cancer.

Propofol inhibits biological functions of leukaemia stem and differentiated cells through suppressing Wnt/β‐catenin and Akt/mTOR

“…The minimal suppression to immune system and low inflammatory response might contribute to the protective effects of propofol in cancer patients. 1 In addition, several preclinical studies focusing on the direct effect of propofol on cancer cells demonstrate that propofol is active against cancer cell biological functions in vitro and in vivo. [11][12][13][14][15] Although the direct anti-cancer activities of propofol have been consistently shown in Table S1).…”

Propofol Compared to Midazolam Sedation and to General Anesthesia for Percutaneous Microwave Ablation in Patients with Hepatic Malignancies: A Single-Center Comparative Analysis of Three Historical Cohorts

“…Interestingly, several in vitro studies describe another potential advantage of propofol—that it may contribute to immune modulation, anti-inflammation and inhibition of cancer cell proliferation and invasion [32, 33].…”

Lidocaine inhibits cytoskeletal remodelling and human breast cancer cell migration

“…Increasing evidence indicates that different classes of anaesthetics can exert either pro-or anti-metastatic effects, which depend on cancer cell type, dosage, and administration protocol. 24 As an example, a potential pro-metastatic role of volatile anaesthetics involving CXCR2 expression has been described in ovarian cancer cells. 25 Our data support further studies to validate the role of lidocaine as an anti-metastatic agent, and for reconsidering the perioperative treatment in breast cancer.…”