Local Anesthetics and Recurrence After Cancer Surgery-What's New? A Narrative Review

Overview

Journal J Clin Med

Specialty General Medicine

Date 2021 Mar 6

PMID 33670434

Citations 13

Authors

Sarah D Muller

Jonathan S H Ziegler

Tobias Piegeler

Affiliations

Soon will be listed here.

Abstract

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.

Citing Articles

Anesthetic Approaches and Their Impact on Cancer Recurrence and Metastasis: A Comprehensive Review.

Choi H, Hwang W Cancers (Basel). 2025; 16(24.

PMID: 39766169 PMC: 11674873. DOI: 10.3390/cancers16244269.

The Role of Anesthetic Management in Lung Cancer Recurrence and Metastasis: A Comprehensive Review.

Huh J, Hwang W J Clin Med. 2024; 13(22).

PMID: 39597826 PMC: 11594908. DOI: 10.3390/jcm13226681.

Chitosan, a Natural Polymer, is an Excellent Sustained-Release Carrier for Amide Local Anesthetics.

Yu Y, Long Y, Zhu Z J Pain Res. 2024; 17:3539-3551.

PMID: 39493932 PMC: 11531737. DOI: 10.2147/JPR.S480926.

Perioperative Immunosuppressive Factors during Cancer Surgery: An Updated Review.

Bezu L, Akcal Oksuz D, Bell M, Buggy D, Diaz-Cambronero O, Enlund M Cancers (Basel). 2024; 16(13).

PMID: 39001366 PMC: 11240822. DOI: 10.3390/cancers16132304.

Ropivacaine suppresses the progression of renal cell carcinoma through regulating the lncRNA RMRP/EZH2/CCDC65 axis.

Xiong Y, Zheng X, Deng H Daru. 2023; 32(1):121-132.

PMID: 38008820 PMC: 11087436. DOI: 10.1007/s40199-023-00492-w.

References

Kang S, Tanaka T, Narazaki M, Kishimoto T . Targeting Interleukin-6 Signaling in Clinic. Immunity. 2019; 50(4):1007-1023. DOI: 10.1016/j.immuni.2019.03.026. View

Le C, Nowell C, Kim-Fuchs C, Botteri E, Hiller J, Ismail H . Chronic stress in mice remodels lymph vasculature to promote tumour cell dissemination. Nat Commun. 2016; 7:10634. PMC: 4773495. DOI: 10.1038/ncomms10634. View

TURNBULL Jr R, Kyle K, Watson F, Spratt J . Cancer of the colon: the influence of the no-touch isolation technic on survival rates. CA Cancer J Clin. 1968; 18(2):82-7. DOI: 10.3322/canjclin.18.2.82. View

Balkwill F, Charles K, Mantovani A . Smoldering and polarized inflammation in the initiation and promotion of malignant disease. Cancer Cell. 2005; 7(3):211-7. DOI: 10.1016/j.ccr.2005.02.013. View

Bundscherer A, Malsy M, Gebhardt K, Metterlein T, Plank C, Wiese C . Effects of ropivacaine, bupivacaine and sufentanil in colon and pancreatic cancer cells in vitro. Pharmacol Res. 2015; 95-96:126-31. DOI: 10.1016/j.phrs.2015.03.017. View

Le Gac G, Angenard G, Clement B, Laviolle B, Coulouarn C, Beloeil H . Local Anesthetics Inhibit the Growth of Human Hepatocellular Carcinoma Cells. Anesth Analg. 2017; 125(5):1600-1609. DOI: 10.1213/ANE.0000000000002429. View

Elajnaf T, Baptista-Hon D, Hales T . Potent Inactivation-Dependent Inhibition of Adult and Neonatal NaV1.5 Channels by Lidocaine and Levobupivacaine. Anesth Analg. 2018; 127(3):650-660. DOI: 10.1213/ANE.0000000000003597. View

Mansour N, BENNETTS F . An observational study of combined continuous lumbar plexus and single-shot sciatic nerve blocks for post-knee surgery analgesia. Reg Anesth. 1996; 21(4):287-91. View

Lang A, Ben Horin S, Picard O, Fudim E, Amariglio N, Chowers Y . Lidocaine inhibits epithelial chemokine secretion via inhibition of nuclear factor kappa B activation. Immunobiology. 2009; 215(4):304-13. DOI: 10.1016/j.imbio.2009.05.006. View

10.

Qiu Z, Wei W, Sun Z, Shen C, Song H, Zhang X . Circulating Tumor Cells Correlate with Clinicopathological Features and Outcomes in Differentiated Thyroid Cancer. Cell Physiol Biochem. 2018; 48(2):718-730. DOI: 10.1159/000491898. View

11.

Lirk P, Hollmann M, Fleischer M, Weber N, Fiegl H . Lidocaine and ropivacaine, but not bupivacaine, demethylate deoxyribonucleic acid in breast cancer cells in vitro. Br J Anaesth. 2014; 113 Suppl 1:i32-8. DOI: 10.1093/bja/aeu201. View

12.

Greten F, Eckmann L, Greten T, Park J, Li Z, Egan L . IKKbeta links inflammation and tumorigenesis in a mouse model of colitis-associated cancer. Cell. 2004; 118(3):285-96. DOI: 10.1016/j.cell.2004.07.013. View

13.

Joshi G, Kehlet H . Postoperative pain management in the era of ERAS: An overview. Best Pract Res Clin Anaesthesiol. 2019; 33(3):259-267. DOI: 10.1016/j.bpa.2019.07.016. View

14.

Roland C, Harken A, Sarr M, Barnett Jr C . ICAM-1 expression determines malignant potential of cancer. Surgery. 2007; 141(6):705-7. DOI: 10.1016/j.surg.2007.01.016. View

15.

Doornebal C, Vrijland K, Hau C, Coffelt S, Ciampricotti M, Jonkers J . Morphine does not facilitate breast cancer progression in two preclinical mouse models for human invasive lobular and HER2⁺ breast cancer. Pain. 2015; 156(8):1424-1432. DOI: 10.1097/j.pain.0000000000000136. View

16.

Yang Y, Bai Z, Yin J, Wu G, Zhang Z . Role of c-Src activity in the regulation of gastric cancer cell migration. Oncol Rep. 2014; 32(1):45-9. PMC: 4067425. DOI: 10.3892/or.2014.3188. View

17.

Hovaguimian F, Braun J, Roth Zgraggen B, Schlapfer M, Dumrese C, Ewald C . Anesthesia and Circulating Tumor Cells in Primary Breast Cancer Patients: A Randomized Controlled Trial. Anesthesiology. 2020; 133(3):548-558. DOI: 10.1097/ALN.0000000000003409. View

18.

Chang Y, Liu C, Chen M, Hsu Y, Chen S, Lin C . Local anesthetics induce apoptosis in human breast tumor cells. Anesth Analg. 2013; 118(1):116-24. DOI: 10.1213/ANE.0b013e3182a94479. View

19.

Schafer Z, Brugge J . IL-6 involvement in epithelial cancers. J Clin Invest. 2007; 117(12):3660-3. PMC: 2096452. DOI: 10.1172/JCI34237. View

20.

Baigrie R, Lamont P, Kwiatkowski D, Dallman M, Morris P . Systemic cytokine response after major surgery. Br J Surg. 1992; 79(8):757-60. DOI: 10.1002/bjs.1800790813. View