The Effect of Anesthesia on the Immune System in Colorectal Cancer Patients

Overview

Journal Can J Gastroenterol Hepatol

Specialty Gastroenterology

Date 2018 May 29

PMID 29805965

Citations 17

Authors

Yangjie Dang

Xingxing Shi

William Xu

Mingzhang Zuo

Affiliations

Soon will be listed here.

Abstract

Colorectal cancer (CRC) is the key leading cause of high morbidity and mortality worldwide. Surgical excision is the most effective treatment for CRC. However, stress caused by surgery response can destroy the body's immunity and increase the likelihood of cancer dissemination and metastasis. Anesthesia is an effective way to control the stress response, and recent basic and clinical research has shown that anesthesia and related drugs can directly or indirectly affect the immune system of colorectal cancer patients during the perioperative period. Thus, these drugs may affect the prognosis of CRC surgery patients. This review is intended to summarize currently available data regarding the effects of anesthetics and related drugs on perioperative immune function and postoperative recurrence and metastasis in CRC patients. Determining the most suitable anesthesia for patients with CRC is of utmost importance.

Citing Articles

Effects of propofol-based total intravenous anesthesia versus desflurane anesthesia on natural killer cell cytotoxicity after hepatocellular carcinoma resection.

Apisutimaitri K, Saeyup P, Suppipat K, Sirichindakul P, Wanasrisant N, Nonsri C J Anaesthesiol Clin Pharmacol. 2024; 40(3):395-402.

PMID: 39391643 PMC: 11463923. DOI: 10.4103/joacp.joacp_174_23.

Pain in Colorectal Surgery: How Does It Occur and What Tools Do We Have for Treatment?.

Ivascu R, Dutu M, Stanca A, Negutu M, Morlova D, Dutu C J Clin Med. 2023; 12(21).

PMID: 37959235 PMC: 10648968. DOI: 10.3390/jcm12216771.

Immunomodulatory and pro-oncologic effects of ketamine and isoflurane anesthetics in a murine model.

Abrahams D, Ibrahim-Hashim A, Ackerman R, Brown J, Whelan C, Garfinkel M PLoS One. 2023; 18(10):e0292492.

PMID: 37816047 PMC: 10564181. DOI: 10.1371/journal.pone.0292492.

The Immunomodulatory Effect of Various Anaesthetic Practices in Patients Undergoing Gastric or Colon Cancer Surgery: A Systematic Review and Meta-Analysis of Randomized Clinical Trials.

Konstantis G, Tsaousi G, Kitsikidou E, Zacharoulis D, Pourzitaki C J Clin Med. 2023; 12(18).

PMID: 37762967 PMC: 10531584. DOI: 10.3390/jcm12186027.

Postoperative Changes in Systemic Immune Tolerance Following Major Oncologic versus Minor Maxillofacial Surgery.

Trumet L, Ries J, Sobl P, Ivenz N, Wehrhan F, Lutz R Cancers (Basel). 2023; 15(15).

PMID: 37568571 PMC: 10417560. DOI: 10.3390/cancers15153755.

References

Liu S, Carpenter R, Neal J . Epidural anesthesia and analgesia. Their role in postoperative outcome. Anesthesiology. 1995; 82(6):1474-506. DOI: 10.1097/00000542-199506000-00019. View

Gottschalk A, Ford J, Regelin C, You J, Mascha E, Sessler D . Association between epidural analgesia and cancer recurrence after colorectal cancer surgery. Anesthesiology. 2010; 113(1):27-34. DOI: 10.1097/ALN.0b013e3181de6d0d. View

Biswas S, Mantovani A . Macrophage plasticity and interaction with lymphocyte subsets: cancer as a paradigm. Nat Immunol. 2010; 11(10):889-96. DOI: 10.1038/ni.1937. View

Beilin B, Shavit Y, Hart J, Mordashov B, Cohn S, Notti I . Effects of anesthesia based on large versus small doses of fentanyl on natural killer cell cytotoxicity in the perioperative period. Anesth Analg. 1996; 82(3):492-7. DOI: 10.1097/00000539-199603000-00011. View

Schneemilch C, Hachenberg T, Ansorge S, Ittenson A, Bank U . Effects of different anaesthetic agents on immune cell function in vitro. Eur J Anaesthesiol. 2005; 22(8):616-23. DOI: 10.1017/s0265021505001031. View

Malmberg K, Bryceson Y, Carlsten M, Andersson S, Bjorklund A, Bjorkstrom N . NK cell-mediated targeting of human cancer and possibilities for new means of immunotherapy. Cancer Immunol Immunother. 2008; 57(10):1541-52. PMC: 11030949. DOI: 10.1007/s00262-008-0492-7. View

Sandel M, Speetjens F, Menon A, Albertsson P, Basse P, Hokland M . Natural killer cells infiltrating colorectal cancer and MHC class I expression. Mol Immunol. 2004; 42(4):541-6. DOI: 10.1016/j.molimm.2004.07.039. View

Zenonos G, Kim J . A T cell-orchestrated immune response in the adult dorsal spinal cord as a cause of neuropathic pain-like hypersensitivity after peripheral nerve damage: a door to novel therapies?. Neurosurgery. 2010; 66(4):N24-5. DOI: 10.1227/01.neu.0000369902.53590.c3. View

Christopherson R, James K, Tableman M, Marshall P, Johnson F . Long-term survival after colon cancer surgery: a variation associated with choice of anesthesia. Anesth Analg. 2008; 107(1):325-32. DOI: 10.1213/ane.0b013e3181770f55. View

10.

Barr J, Donner A . Optimal intravenous dosing strategies for sedatives and analgesics in the intensive care unit. Crit Care Clin. 1995; 11(4):827-47. View

11.

Tartter P . The association of perioperative blood transfusion with colorectal cancer recurrence. Ann Surg. 1992; 216(6):633-8. PMC: 1242709. DOI: 10.1097/00000658-199212000-00004. View

12.

Woods G, Griffiths D . Reversible inhibition of natural killer cell activity by volatile anaesthetic agents in vitro. Br J Anaesth. 1986; 58(5):535-9. DOI: 10.1093/bja/58.5.535. View

13.

Nagorsen D, Keilholz U, Rivoltini L, Schmittel A, Letsch A, Asemissen A . Natural T-cell response against MHC class I epitopes of epithelial cell adhesion molecule, her-2/neu, and carcinoembryonic antigen in patients with colorectal cancer. Cancer Res. 2000; 60(17):4850-4. View

14.

Fleischmann E, Marschalek C, Schlemitz K, Dalton J, Gruenberger T, Herbst F . Nitrous oxide may not increase the risk of cancer recurrence after colorectal surgery: a follow-up of a randomized controlled trial. BMC Anesthesiol. 2009; 9:1. PMC: 2660895. DOI: 10.1186/1471-2253-9-1. View

15.

Mrakovcic-Sutic I, Bacic D, Golubovic S, Bacic R, Marinovic M . Cross-talk between NKT and regulatory T cells (Tregs) in modulation of immune response in patients with colorectal cancer following different pain management techniques. Coll Antropol. 2012; 35 Suppl 2:57-60. View

16.

Siegel R, Miller K, Jemal A . Cancer Statistics, 2017. CA Cancer J Clin. 2017; 67(1):7-30. DOI: 10.3322/caac.21387. View

17.

Ash S, Buggy D . Does regional anaesthesia and analgesia or opioid analgesia influence recurrence after primary cancer surgery? An update of available evidence. Best Pract Res Clin Anaesthesiol. 2013; 27(4):441-56. DOI: 10.1016/j.bpa.2013.10.005. View

18.

Kim S, Iizuka K, Aguila H, Weissman I, Yokoyama W . In vivo natural killer cell activities revealed by natural killer cell-deficient mice. Proc Natl Acad Sci U S A. 2000; 97(6):2731-6. PMC: 15998. DOI: 10.1073/pnas.050588297. View

19.

Allavena P, Sica A, Garlanda C, Mantovani A . The Yin-Yang of tumor-associated macrophages in neoplastic progression and immune surveillance. Immunol Rev. 2008; 222:155-61. DOI: 10.1111/j.1600-065X.2008.00607.x. View

20.

Katoh H, Yamashita K, Wang G, Sato T, Nakamura T, Watanabe M . Anastomotic leakage contributes to the risk for systemic recurrence in stage II colorectal cancer. J Gastrointest Surg. 2010; 15(1):120-9. DOI: 10.1007/s11605-010-1379-4. View