Journal of Anesthesiology V 94, No 6, Jun 2001
Surgical resection of tumors is an important aspect of cancer treatment. Unfortunately, it is becoming apparent that the perioperative period is characterized by pronounced immunosuppression, including a reduction in the activity of natural killer (NK) cells and macrophages, which know to spontaneously recognize and kill a variety of tumor cells. This fact may increase metastatic development at this susceptible period, hence the description of the surgical option for cancer as a “doubleedged sword.”
Many factors have been shown to contribute to perioperative immunosuppression, among them anesthetic agents, blood transfusion, hypothermia, and psychological stress. Importantly, regional anesthesia has been repeatedly shown to attenuate this stress response, a fact that may underlie the reduced immunosuppression elicited by surgical procedures conducted with regional anesthesia (either spinal or epidural block) compared with general anesthesia. Attenuating immunosuppression may reduce the metastasis-promoting effects of surgery.
Thus, in the current study we sought to assess whether the use of regional anesthesia, specifically spinal block, attenuates the promotion of metastasis by surgery.
Complete study here: Tumor promoting effect of surgery