Local Anesthetics and Recurrence after Cancer Surgery-What's New? A Narrative Review.
Sarah D MüllerJonathan S H ZieglerTobias PiegelerPublished in: Journal of clinical medicine (2021)
The perioperative use of regional anesthesia and local anesthetics is part of almost every anesthesiologist's daily clinical practice. Retrospective analyses and results from experimental studies pointed towards a potential beneficial effect of the local anesthetics regarding outcome-i.e., overall and/or recurrence-free survival-in patients undergoing cancer surgery. The perioperative period, where the anesthesiologist is responsible for the patients, might be crucial for the further course of the disease, as circulating tumor cells (shed from the primary tumor into the patient's bloodstream) might form new micro-metastases independent of complete tumor removal. Due to their strong anti-inflammatory properties, local anesthetics might have a certain impact on these circulating tumor cells, either via direct or indirect measures, for example via blunting the inflammatory stress response as induced by the surgical stimulus. This narrative review highlights the foundation of these principles, features recent experimental and clinical data and provides an outlook regarding current and potential future research activities.
Keyphrases
- circulating tumor cells
- patients undergoing
- free survival
- papillary thyroid
- minimally invasive
- end stage renal disease
- coronary artery bypass
- clinical practice
- squamous cell
- anti inflammatory
- circulating tumor
- ejection fraction
- cardiac surgery
- chronic kidney disease
- newly diagnosed
- peritoneal dialysis
- surgical site infection
- machine learning
- case report
- squamous cell carcinoma
- cross sectional
- electronic health record
- big data
- lymph node metastasis
- risk assessment
- coronary artery disease
- deep learning
- young adults
- klebsiella pneumoniae
- acute coronary syndrome
- atrial fibrillation