Optimum perioperative patient care requires individual assessment of the impact of cancer and its treatment on major organ systems, and the potential of anaesthetic technique to influence long-term cancer outcomes merits further investigation.
Hypothesis-generating for regional anesthesia reducing metastasis after cancer surgery; should not change practice without randomized evidence.
PURPOSE OF REVIEW: Cancer is beginning to outpace cardiovascular disease as the primary cause of death in the developed world. A majority of cancer patients will require anaesthesia either for primary debulking tumour removal or to treat an adverse consequence of the malignant process or its treatment. Therefore we outline here the pathophysiology of cancer, generalized metastatic disease and systemic chemotherapy and radiotherapy on major organ systems. The anaesthetic considerations for optimum perioperative management of cancer patients are discussed, and the possibility of anaesthetic technique at primary cancer surgery affecting long-term cancer outcome is mentioned. RECENT FINDINGS: Cancer and its therapy can adversely affect every major organ system with profound implications for perioperative management. Retrospective analysis suggests an association between regional anaesthetic techniques at primary cancer surgery and reduced incidence of metastatic disease. SUMMARY: Optimum perioperative patient care requires individual assessment of the impact of cancer and its treatment on the functional reserve of all major organ systems. The potential of anaesthetic technique at cancer surgery to influence long-term cancer outcome merits investigation.
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Arain et al. (2007) studied this question.
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