Anesthetic technique and cancer recurrence in oncologic surgery: unraveling the puzzle.

摘要: Surgery/anesthetic technique-stimulated immunosuppression in the perioperative period might cause an increase cancer-related mortality. Whether anesthetic technique can affect outcomes of cancer patients remains inconclusive. This review discusses data from available literature on techniques applied oncologic surgery, long-term technique, and their relation to survival recurrence. Searches PubMed database up June 30, 2016, were conducted identify publications with terms "anesthetic recurrence," "regional anesthesia "local immunosuppression," surgery." Surgery/anesthesia-stimulated activation hypothalamic-pituitary-adrenal (HPA) axis sympathetic nervous system (SNS) provides through several soluble factors. Volatile anesthetics opioids suppress cell-mediated immunity (CMI) promote proliferation cells angiogenesis, whereas propofol does not CMI inhibits tumor angiogenesis. Regional (RA) protects diminishes surgical neuroendocrine stress response by blocking afferent neural transmission that stimulates HPA SNS, decreasing requirement for volatile thereby Preclinical retrospective studies highlight a potential benefit reducing mortality recurrence attenuating following treatment specific types cancer. Several well-planned, prospective, randomized controlled trials (RCTs) are underway may provide more conclusive definitive results regarding benefits surgery.