Tumour excisional surgery, anaesthetic-analgesic techniques, and oncologic outcomes: a narrative review.

Orla Murphy, Patrice Forget, Daqing Ma, Donal J Buggy

Journal: British journal of anaesthesia 2023;131(6):989-1001

PMID: 37689540

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Abstract

Cancer is a growing global burden; there were an estimated 18 million new cancer diagnoses worldwide in 2020. Excisional surgery remains one of the main treatments for solid organ tumours in cancer patients and is potentially curative. Cancer- and surgery-induced inflammatory processes can facilitate residual tumour cell survival, growth, and subsequent recurrence. However, it has been hypothesised that anaesthetic and analgesic techniques during surgery might influence the risk of cancer recurrence. This narrative review aims to provide an updated summary of recent observational studies and new randomised controlled clinical trials on whether certain specific anaesthetic and analgesic techniques or perioperative interventions during tumour resection surgery of curative intent materially affect long-term oncologic outcomes.

Address: Department of Anaesthesiology and Perioperative Medicine, Mater University Hospital, School of Medicine, University College Dublin, Dublin, Ireland.; Epidemiology Group, Institute of Applied Health Sciences, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK; Department of Anaesthesia, NHS Grampian, Aberdeen, UK; Euro-Periscope, The ESA-IC OncoAnaesthesiology Research Group.; Euro-Periscope, The ESA-IC OncoAnaesthesiology Research Group; Division of Anaesthetics, Pain Medicine and Intensive Care, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK.; Department of Anaesthesiology and Perioperative Medicine, Mater University Hospital, School of Medicine, University College Dublin, Dublin, Ireland; Euro-Periscope, The ESA-IC OncoAnaesthesiology Research Group; Outcomes Research, Cleveland Clinic, Cleveland, OH, USA. Electronic address: [email protected].

DOI: 10.1016/j.bja.2023.07.027

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MeSH Terms: Humans, Neoplasm Recurrence, Local, Anesthesia, Anesthetics, Analgesics