The Potential Effect of General Anesthetics in Cancer Surgery: Meta-Analysis of Postoperative Metastasis and Inflammatory Cytokines
Metastasis or recurrence following curative surgery is the main indicator of tumor progress and is the main cause of patient death. For more than three decades, the potential for general anesthesia to affect cancer outcomes has been a subject of concern with considerable research interest. Here, we...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-05-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/15/10/2759 |
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| author | Ru Li Mousumi Beto Mukherjee Zhaosheng Jin Hengrui Liu Kevin Lin Qiuyue Liu James P. Dilger Jun Lin |
| author_facet | Ru Li Mousumi Beto Mukherjee Zhaosheng Jin Hengrui Liu Kevin Lin Qiuyue Liu James P. Dilger Jun Lin |
| author_sort | Ru Li |
| collection | DOAJ |
| description | Metastasis or recurrence following curative surgery is the main indicator of tumor progress and is the main cause of patient death. For more than three decades, the potential for general anesthesia to affect cancer outcomes has been a subject of concern with considerable research interest. Here, we conducted this systematic review and meta-analysis to summarize the effect of inhalational anesthesia (IHNA) vs. propofol-based total intravenous anesthesia (TIVA) on metastasis and recurrence after cancer surgery from clinical and pre-clinical studies. The relative risk for metastasis/recurrence in TIVA is 0.61 (95% confidence interval (95% CI) 0.46 to 0.82, <i>p</i> = 0.0009) compared to IHNA. Inflammatory cytokines have been implicated in cancer metastasis following cancer surgery, thus we analyzed inflammatory cytokines levels after surgery under IHNA or TIVA. Based on pooled analysis, a lower IL-6 level was noticed in TIVA in comparison to IHNA (standardized mean difference (SMD) = 0.77, 95% CI = 0.097 to 1.44, I<sup>2</sup> = 92%, <i>p</i> = 0.02) but not TNF-α or IL-10. Preclinical animal model studies show that inhalational anesthetics increase the risk of breast cancer metastasis compared to propofol. In conclusion, the current evidence suggests intravenous anesthetic propofol is associated with less metastasis/recurrence and lower postoperative IL-6 level over inhaled anesthetics in the oncological surgery. We urge more well-designed clinical and preclinical studies in this field. |
| first_indexed | 2024-03-11T03:51:47Z |
| format | Article |
| id | doaj.art-7d66078313544f6d9ba35f45c83c5dee |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-11T03:51:47Z |
| publishDate | 2023-05-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-7d66078313544f6d9ba35f45c83c5dee2023-11-18T00:48:31ZengMDPI AGCancers2072-66942023-05-011510275910.3390/cancers15102759The Potential Effect of General Anesthetics in Cancer Surgery: Meta-Analysis of Postoperative Metastasis and Inflammatory CytokinesRu Li0Mousumi Beto Mukherjee1Zhaosheng Jin2Hengrui Liu3Kevin Lin4Qiuyue Liu5James P. Dilger6Jun Lin7Department of Anesthesiology, Stony Brook University Renaissance School of Medicine, Stony Brook, NY 11794-8480, USADepartment of Anesthesiology, Stony Brook University Renaissance School of Medicine, Stony Brook, NY 11794-8480, USADepartment of Anesthesiology, Stony Brook University Renaissance School of Medicine, Stony Brook, NY 11794-8480, USADepartment of Anesthesiology, Stony Brook University Renaissance School of Medicine, Stony Brook, NY 11794-8480, USADepartment of Anesthesiology, Stony Brook University Renaissance School of Medicine, Stony Brook, NY 11794-8480, USADepartment of Anesthesiology, Stony Brook University Renaissance School of Medicine, Stony Brook, NY 11794-8480, USADepartment of Anesthesiology, Stony Brook University Renaissance School of Medicine, Stony Brook, NY 11794-8480, USADepartment of Anesthesiology, Stony Brook University Renaissance School of Medicine, Stony Brook, NY 11794-8480, USAMetastasis or recurrence following curative surgery is the main indicator of tumor progress and is the main cause of patient death. For more than three decades, the potential for general anesthesia to affect cancer outcomes has been a subject of concern with considerable research interest. Here, we conducted this systematic review and meta-analysis to summarize the effect of inhalational anesthesia (IHNA) vs. propofol-based total intravenous anesthesia (TIVA) on metastasis and recurrence after cancer surgery from clinical and pre-clinical studies. The relative risk for metastasis/recurrence in TIVA is 0.61 (95% confidence interval (95% CI) 0.46 to 0.82, <i>p</i> = 0.0009) compared to IHNA. Inflammatory cytokines have been implicated in cancer metastasis following cancer surgery, thus we analyzed inflammatory cytokines levels after surgery under IHNA or TIVA. Based on pooled analysis, a lower IL-6 level was noticed in TIVA in comparison to IHNA (standardized mean difference (SMD) = 0.77, 95% CI = 0.097 to 1.44, I<sup>2</sup> = 92%, <i>p</i> = 0.02) but not TNF-α or IL-10. Preclinical animal model studies show that inhalational anesthetics increase the risk of breast cancer metastasis compared to propofol. In conclusion, the current evidence suggests intravenous anesthetic propofol is associated with less metastasis/recurrence and lower postoperative IL-6 level over inhaled anesthetics in the oncological surgery. We urge more well-designed clinical and preclinical studies in this field.https://www.mdpi.com/2072-6694/15/10/2759sevofluraneisofluranedesfluraneinhalational anesthesiapropofoltotal intravenous anesthesia |
| spellingShingle | Ru Li Mousumi Beto Mukherjee Zhaosheng Jin Hengrui Liu Kevin Lin Qiuyue Liu James P. Dilger Jun Lin The Potential Effect of General Anesthetics in Cancer Surgery: Meta-Analysis of Postoperative Metastasis and Inflammatory Cytokines Cancers sevoflurane isoflurane desflurane inhalational anesthesia propofol total intravenous anesthesia |
| title | The Potential Effect of General Anesthetics in Cancer Surgery: Meta-Analysis of Postoperative Metastasis and Inflammatory Cytokines |
| title_full | The Potential Effect of General Anesthetics in Cancer Surgery: Meta-Analysis of Postoperative Metastasis and Inflammatory Cytokines |
| title_fullStr | The Potential Effect of General Anesthetics in Cancer Surgery: Meta-Analysis of Postoperative Metastasis and Inflammatory Cytokines |
| title_full_unstemmed | The Potential Effect of General Anesthetics in Cancer Surgery: Meta-Analysis of Postoperative Metastasis and Inflammatory Cytokines |
| title_short | The Potential Effect of General Anesthetics in Cancer Surgery: Meta-Analysis of Postoperative Metastasis and Inflammatory Cytokines |
| title_sort | potential effect of general anesthetics in cancer surgery meta analysis of postoperative metastasis and inflammatory cytokines |
| topic | sevoflurane isoflurane desflurane inhalational anesthesia propofol total intravenous anesthesia |
| url | https://www.mdpi.com/2072-6694/15/10/2759 |
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