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Review
. 2023 May 26;30(6):5309-5321.
doi: 10.3390/curroncol30060403.

Anaesthetic Techniques and Strategies: Do They Influence Oncological Outcomes?

Liam Murphy  1 , John Shaker  1 , Donal J Buggy  1   2   3
Affiliations
Review

Anaesthetic Techniques and Strategies: Do They Influence Oncological Outcomes?

Liam Murphy et al. Curr Oncol. .

Abstract

Background: With the global disease burden of cancer increasing, and with at least 60% of cancer patients requiring surgery and, hence, anaesthesia over their disease course, the question of whether anaesthetic and analgesia techniques during primary cancer resection surgery might influence long term oncological outcomes assumes high priority.

Methods: We searched the available literature linking anaesthetic-analgesic techniques and strategies during tumour resection surgery to oncological outcomes and synthesised this narrative review, predominantly using studies published since 2019. Current evidence is presented around opioids, regional anaesthesia, propofol total intravenous anaesthesia (TIVA) and volatile anaesthesia, dexamethasone, dexmedetomidine, non-steroidal anti-inflammatory medications and beta-blockers.

Conclusions: The research base in onco-anaesthesia is expanding. There continue to be few sufficiently powered RCTs, which are necessary to confirm a causal link between any perioperative intervention and long-term oncologic outcome. In the absence of any convincing Level 1 recommending a change in practice, long-term oncologic benefit should not be part of the decision on choice of anaesthetic technique for tumour resection surgery.

Keywords: anaesthesia; cancer metastasis; cancer recurrence; cancer surgery; onco-anaesthesia; postoperative analgesia; regional anaesthesia; surgery; total intravenous anaesthesia; volatile anaesthesia.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Schematic representation of the pathophysiological mechanisms induced by surgery that promote survival and growth of metastatic deposits formed by circulating tumour cells (CTCs) released intraoperatively. COX-2, cyclo-oxygenase-2; HIF, hypoxia-inducible factor; HPA, hypothalamic-pituitary-adrenal axis; IL-6, interleukin 6; MMP, matrix metalloprotease; NF-kB, nuclear factor kappa B; NK, natural killer cell; Th2, Type 2 helper T cell; Treg, regulatory T-cell; VEGF, vascular endothelial growth factor.
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References

    1. Global Burden of Disease 2019 Cancer Collaboration. Kocarnik J.M., Compton K., Dean F.E., Fu W., Gaw B.L., Harvey J.D., Henrikson H.J., Lu D., Pennini A., et al. Cancer Incidence, Mortality, Years of Life Lost, Years Lived With Disability, and Disability-Adjusted Life Years for 29 Cancer Groups from 2010 to 2019. JAMA Oncol. 2021;8:420–444. doi: 10.1001/jamaoncol.2021.6987. - DOI - PMC - PubMed
    1. Foreman K.J., Marquez N., Dolgert A., Fukutaki K., Fullman N., McGaughey M., Pletcher M.A., Smith A.E., Tang K., Yuan C.-W., et al. Forecasting life expectancy, years of life lost, and all-cause and cause-specific mortality for 250 causes of death: Reference and alternative scenarios for 2016–40 for 195 countries and territories. [(accessed on 5 January 2023)];Lancet. 2018 392:2052–2090. doi: 10.1016/S0140-6736(18)31694-5. Available online: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)31694.... - DOI - PMC - PubMed
    1. Moorthy A., Eochagáin A.N., Buggy D.J. Can Acute Postoperative Pain Management After Tumour Resection Surgery Modulate Risk of Later Recurrence or Metastasis? Front. Oncol. 2021;11:802592. doi: 10.3389/fonc.2021.802592. - DOI - PMC - PubMed
    1. Murphy O., Forget P., Ma D., Buggy D.J. Anesthetic technique and cancer surgery outcomes. Br. J. Anaesth. 2023 in press . - PubMed
    1. Wall T., Sherwin A., Ma D., Buggy D. Influence of perioperative anaesthetic and analgesic interventions on oncological outcomes: A narrative review. Br. J. Anaesth. 2019;123:135–150. doi: 10.1016/j.bja.2019.04.062. - DOI - PMC - PubMed