Choice of anesthesia may have role in long-term outcomes and risk of cancer recurrence
MONDAY, June 7 (HealthDay News) -- The use of anesthesia during cancer surgery may impact long-term outcomes and risk of cancer recurrence, according to two articles published in the June issue of Anesthesia & Analgesia.
In a review article, Antje Gottschalk, M.D., of the University of Virginia in Charlottesville, and colleagues write that surgical stress response may increase the risk of cancer dissemination during and after surgery, and anesthetic management thereby has potential in impacting long-term outcomes. According to their report, preclinical data suggest that beneficial approaches include use of induction drugs such as propofol, reduction of use of volatile anesthetics, and administration of cyclooxygenase antagonists in combination with systemic opioids. The authors also write that retrospective clinical trials suggest that adding regional anesthesia might reduce the rate of recurrence after cancer surgery.
In a retrospective analysis, Patrice Forget, M.D., of the Université catholique de Louvain in Belgium, and colleagues evaluated 327 consecutive women who underwent mastectomy with axillary dissection for breast cancer to compare the incidence of cancer recurrence among patients who received different analgesics during surgery. The researchers found that intraoperative administration of ketorolac was associated with a decreased disease relapse rate but other analgesics were not.
"In conclusion, even though the evidence is inconclusive and at times conflicting, we cannot ignore the possibility that anesthesia may contribute to the recurrence of cancer, months or even years after cancer surgery," writes the author of an accompanying editorial.
Abstract - Gottschalk
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Abstract - Forget
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Editorial