Table 3 Effect of anesthetic agents on tumor development
From: Effects of surgery and anesthetic choice on immunosuppression and cancer recurrence
Agent | Experimental data | Clinical data |
|---|---|---|
Intravenous | ||
Ketamine | Stimulator of lung and liver metastasis [65] Increase in lung tumor retention or lung metastasis [66] Increase in lung tumor retention or lung metastasis [66] Inhibition of HIF-1α activation [71] Prevention of isoflurane-induced HIF-1α activation [71] Antitumor effect [18] | |
Thiopental | ||
Propofol | ||
Volatile anesthetics | ||
Halothane | Stimulator of lung and liver metastasis [65] Suppression of hypoxia-induced growth and metastasis of lung cancer cells [35] Increased proliferation, migration, and invasion of breast cancer cells [77] | Serum from sevoflurane/opioid anesthesia-analgesia for breast cancer surgery attenuates the inhibition of breast cancer cell proliferation [69] Increased expression of pro-oncogenic protein markers in head and neck squamous cell carcinoma cells [70] |
Sevoflurane | ||
Isoflurane | Upregulation of HIF-1α in prostate cancer cell line [71] Increase in malignant potential of ovarian cancer cells [72] Resistance against apoptosis via a Cav-1-dependent mechanism in cancer cells [73] | |
Nitrous oxide | Suppression of neutrophil chemotaxis, potentially facilitating the spread of cancer [18] Potent stimulator of lung and liver metastasis [65] | No effect on colorectal carcinoma recurrence [87] |
Opioids | ||
Morphine | Promotion of tumor growth (single-dose or low dose) [81] Involvement of MOR in tumor development [85,86,87] Promotion of tumor growth and metastasis by MOR overexpression [85] Proangiogenic and proliferative effects in breast cancer xenografts [76, 90] Increase in endothelial cell proliferation expressed with mu3 opioid receptor [91] Stimulation of Rho A and Src activation downstream of the VEGFR [88] Direct effect of morphine on breast cancer cell migration via NET1 [68] Reduction in growth of certain tumors in part through activation of p53 [82] Attenuation of MMP secretion under the control of nitric oxide system [83] Beneficial effects on surgery-induced increases in metastasis by pre-surgical administration of morphine [93] Protective effect against metastasis development [34] Antitumor-like effects on colorectal cancer cells [95, 96] No change in apoptosis rate or cell cycle distribution at clinical concentrations [97] | Increase in MOR expression in patients with non-small cell lung cancer [86] and metastatic lung cancer [84] A possible adjuvant therapy of MNTX for patients with advanced cancer [88] Intraoperative opioid use is associated with decreased OS in stage I but not stage II-III NSCLC patients [94] |
Fentanyl | ||
Sufentanil | ||
Others | ||
COX-2 inhibitor | Antitumor and antiangiogenic properties [99] Reduction of ketamine-induced lung metastasis [81] | Reduced risk of breast and colorectal cancer [100, 101] Use of COX-2 inhibitor was associated with one-fifth reduction in breast cancer recurrence [102] |
β-adrenergic antagonist | ||
Local anesthetics | ||
Lidocaine | Antitumor effect of lidocaine via the inhibition of EGF/EGFR pathway in human tongue cancer cells [105] Apoptotic cell death by lidocaine and bupivacaine in breast cancer cells [106] Demethylation of DNA in breast cancer cell lines [108] Inhibition of cancer cell invasion [109] Reduced proliferation of mesenchymal stem cells [104] Decreased metastatic progression in breast tumor cells [107] Reduced proliferation of MSCs [104] No change in apoptosis rate or cell cycle distribution at clinical concentrations [97] | |
Lidocaine/tetracaine | ||
Ropivacaine/bupivacaine | ||