Fundamental Principles of Cancer Biology: Does it have relevance to the perioperative period?
- PMID: 26388704
- PMCID: PMC4570734
- DOI: 10.1007/s40140-015-0122-9
Fundamental Principles of Cancer Biology: Does it have relevance to the perioperative period?
Abstract
Malignant tumors are characterized by their ability to metastasize, which is the main cause of cancer-related mortality. Besides intrinsic alternations in cancer cells, the tumor microenvironment plays a pivotal role in tumor growth and metastasis. Ample evidence suggests that the perioperative period and the excision of the primary tumor can promote the development of metastases and can influence long-term cancer patient outcomes. The role of cancer biology and its impact on the perioperative period are of increasing interest. This review will present evidence regarding fundamental principles of cancer biology, especially tumor microenvironment, and discuss new therapeutic opportunities in the perioperative timeframe. We will also discuss the regulatory signaling that could be relevant to various aspects of surgery and surgical responses, which could facilitate the metastatic process by directly or indirectly affecting malignant tissues and the tumor microenvironment. We address the influences of surgery-related stress, anesthetic and analgesic agents, blood transfusion, hypothermia, and β-adrenergic blockade administration on tumor growth and metastasis. Through an improved understanding of these processes, we will provide suggestions for potential new perioperative approaches aimed at improving treatment outcomes of cancer patients.
Keywords: Perioperative; cancer biology; therapeutics.
Conflict of interest statement
Li Jiang, Alpa M. Nick, and Anil K. Sood declare that they have no conflict of interest.
References
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- Hanahan D, Weinberg RA. Hallmarks of cancer: the next generation. Cell. 2011;144(5):646–674. - PubMed
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Hanahan D, Weinberg RA. The hallmarks of cancer. Cell. 2000;100(1):57–70. This paper provides a very important summary of the key factors that play a role in promoting cancer growth and progression.
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Horowitz M, et al. Exploiting the critical perioperative period to improve long-term cancer outcomes. Nat Rev Clin Oncol. 2015;12(4):213–226. This paper summarizes various opportunities in the perioperative time period.
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