Sleeping Beauty: Anesthesia May Promote Relapse in Dogs With Diffuse Large B-Cell Lymphoma in Complete Remission After Chemo-Immunotherapy
Surgery-induced stress and anesthesia-related immunosuppression are believed to play a critical role in human oncology patients. Studies have hypothesized that anesthesia influences patients' outcome, promoting tumor recurrence and metastasis. Aim of the study was to investigate whether anesthe...
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| Format: | Article |
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Frontiers Media S.A.
2021-11-01
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| Series: | Frontiers in Veterinary Science |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fvets.2021.760603/full |
| _version_ | 1819005203392757760 |
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| author | Eugenio Faroni Silvia Sabattini Jacopo Lenzi Dina Guerra Stefano Comazzi Luca Aresu Alessia Mazzanti Stefano Zanardi Veronica Cola Emilio Lotito Laura Marconato |
| author_facet | Eugenio Faroni Silvia Sabattini Jacopo Lenzi Dina Guerra Stefano Comazzi Luca Aresu Alessia Mazzanti Stefano Zanardi Veronica Cola Emilio Lotito Laura Marconato |
| author_sort | Eugenio Faroni |
| collection | DOAJ |
| description | Surgery-induced stress and anesthesia-related immunosuppression are believed to play a critical role in human oncology patients. Studies have hypothesized that anesthesia influences patients' outcome, promoting tumor recurrence and metastasis. Aim of the study was to investigate whether anesthesia promoted relapse in dogs with diffuse large B-cell lymphoma (DLBCL). Medical records were searched for dogs with DLBCL, that were in complete remission (CR) after the same chemo-immunotherapy protocol. Dogs receiving anesthesia were included if the procedure was performed while in CR. Time to relapse (TTR) was obtained via Kaplan–Meier method. Association between anesthesia and relapse was assessed using a nested case-control design and estimated using conditional logistic regression. Sixty-one dogs with DLBCL were included. Overall median TTR was 329 days (95% CI, 281–377). Forty-eight (79%) dogs relapsed during the study period, while 13 (21%) were still in CR at data analysis closure. Eighteen (30%) dogs received anesthesia with opioids, propofol, and isoflurane or sevoflurane. The relative risk of lymphoma relapse for dogs undergoing anesthesia was significantly higher compared with dogs not undergoing anesthesia, with an odds ratio of 3.09 (P = 0.019) on multivariable analysis. Anesthesia may promote relapse in dogs with DLBCL treated with chemo-immunotherapy, although a role of perioperative stress cannot be ultimately excluded. Considering the high frequency of anesthetic procedures required for diagnostic and therapeutic protocols among oncology patients, it is of utmost interest to characterize the effects of single anesthetic agents on the immune system. Further prospective studies are needed to better define the impact of anesthesia on patients' outcome. |
| first_indexed | 2024-12-20T23:49:03Z |
| format | Article |
| id | doaj.art-f720dc286db749d0b6ef1d26cf40d179 |
| institution | Directory Open Access Journal |
| issn | 2297-1769 |
| language | English |
| last_indexed | 2024-12-20T23:49:03Z |
| publishDate | 2021-11-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Veterinary Science |
| spelling | doaj.art-f720dc286db749d0b6ef1d26cf40d1792022-12-21T19:22:53ZengFrontiers Media S.A.Frontiers in Veterinary Science2297-17692021-11-01810.3389/fvets.2021.760603760603Sleeping Beauty: Anesthesia May Promote Relapse in Dogs With Diffuse Large B-Cell Lymphoma in Complete Remission After Chemo-ImmunotherapyEugenio Faroni0Silvia Sabattini1Jacopo Lenzi2Dina Guerra3Stefano Comazzi4Luca Aresu5Alessia Mazzanti6Stefano Zanardi7Veronica Cola8Emilio Lotito9Laura Marconato10Department of Veterinary Medical Sciences, Alma Mater Studiorum University of Bologna, Bologna, ItalyDepartment of Veterinary Medical Sciences, Alma Mater Studiorum University of Bologna, Bologna, ItalyDepartment of Biomedical and Neuromotor Sciences, Alma Mater Studiorum University of Bologna, Bologna, ItalyDepartment of Veterinary Medical Sciences, Alma Mater Studiorum University of Bologna, Bologna, ItalyDepartment of Veterinary Medicine, University of Milano, Lodi, ItalyDepartment of Veterinary Sciences, University of Torino, Turin, ItalyDepartment of Veterinary Medical Sciences, Alma Mater Studiorum University of Bologna, Bologna, ItalyDepartment of Veterinary Medical Sciences, Alma Mater Studiorum University of Bologna, Bologna, ItalyDepartment of Veterinary Medical Sciences, Alma Mater Studiorum University of Bologna, Bologna, ItalyClinica Veterinaria Dell'Orologio, Sasso Marconi, Bologna, ItalyDepartment of Veterinary Medical Sciences, Alma Mater Studiorum University of Bologna, Bologna, ItalySurgery-induced stress and anesthesia-related immunosuppression are believed to play a critical role in human oncology patients. Studies have hypothesized that anesthesia influences patients' outcome, promoting tumor recurrence and metastasis. Aim of the study was to investigate whether anesthesia promoted relapse in dogs with diffuse large B-cell lymphoma (DLBCL). Medical records were searched for dogs with DLBCL, that were in complete remission (CR) after the same chemo-immunotherapy protocol. Dogs receiving anesthesia were included if the procedure was performed while in CR. Time to relapse (TTR) was obtained via Kaplan–Meier method. Association between anesthesia and relapse was assessed using a nested case-control design and estimated using conditional logistic regression. Sixty-one dogs with DLBCL were included. Overall median TTR was 329 days (95% CI, 281–377). Forty-eight (79%) dogs relapsed during the study period, while 13 (21%) were still in CR at data analysis closure. Eighteen (30%) dogs received anesthesia with opioids, propofol, and isoflurane or sevoflurane. The relative risk of lymphoma relapse for dogs undergoing anesthesia was significantly higher compared with dogs not undergoing anesthesia, with an odds ratio of 3.09 (P = 0.019) on multivariable analysis. Anesthesia may promote relapse in dogs with DLBCL treated with chemo-immunotherapy, although a role of perioperative stress cannot be ultimately excluded. Considering the high frequency of anesthetic procedures required for diagnostic and therapeutic protocols among oncology patients, it is of utmost interest to characterize the effects of single anesthetic agents on the immune system. Further prospective studies are needed to better define the impact of anesthesia on patients' outcome.https://www.frontiersin.org/articles/10.3389/fvets.2021.760603/fullanesthesiadogimmunosuppressionlymphomapropofolTIVA |
| spellingShingle | Eugenio Faroni Silvia Sabattini Jacopo Lenzi Dina Guerra Stefano Comazzi Luca Aresu Alessia Mazzanti Stefano Zanardi Veronica Cola Emilio Lotito Laura Marconato Sleeping Beauty: Anesthesia May Promote Relapse in Dogs With Diffuse Large B-Cell Lymphoma in Complete Remission After Chemo-Immunotherapy Frontiers in Veterinary Science anesthesia dog immunosuppression lymphoma propofol TIVA |
| title | Sleeping Beauty: Anesthesia May Promote Relapse in Dogs With Diffuse Large B-Cell Lymphoma in Complete Remission After Chemo-Immunotherapy |
| title_full | Sleeping Beauty: Anesthesia May Promote Relapse in Dogs With Diffuse Large B-Cell Lymphoma in Complete Remission After Chemo-Immunotherapy |
| title_fullStr | Sleeping Beauty: Anesthesia May Promote Relapse in Dogs With Diffuse Large B-Cell Lymphoma in Complete Remission After Chemo-Immunotherapy |
| title_full_unstemmed | Sleeping Beauty: Anesthesia May Promote Relapse in Dogs With Diffuse Large B-Cell Lymphoma in Complete Remission After Chemo-Immunotherapy |
| title_short | Sleeping Beauty: Anesthesia May Promote Relapse in Dogs With Diffuse Large B-Cell Lymphoma in Complete Remission After Chemo-Immunotherapy |
| title_sort | sleeping beauty anesthesia may promote relapse in dogs with diffuse large b cell lymphoma in complete remission after chemo immunotherapy |
| topic | anesthesia dog immunosuppression lymphoma propofol TIVA |
| url | https://www.frontiersin.org/articles/10.3389/fvets.2021.760603/full |
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