Effects of Perioperative Epidural Analgesia on Cancer Recurrence and Survival

Surgical resection is the main curative avenue for various cancers. Unfortunately, cancer recurrence following surgery is commonly seen, and typically results in refractory disease and death. Currently, there is no consensus whether perioperative epidural analgesia (EA), including intraoperative and...

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Published inFrontiers in oncology Vol. 11; p. 798435
Main Authors Zhang, Donghang, Jiang, Jingyao, Liu, Jin, Zhu, Tao, Huang, Han, Zhou, Cheng
Format Journal Article
LanguageEnglish
Published Switzerland Frontiers Media S.A 05.01.2022
Subjects
cancer recurrence
cancer surgeries
cancer survival
epidural analgesia
oncological outcomes
Oncology
oncological outcomes
epidural analgesia
cancer recurrence
cancer surgeries
cancer survival
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Summary:Surgical resection is the main curative avenue for various cancers. Unfortunately, cancer recurrence following surgery is commonly seen, and typically results in refractory disease and death. Currently, there is no consensus whether perioperative epidural analgesia (EA), including intraoperative and postoperative epidural analgesia, is beneficial or harmful on cancer recurrence and survival. Although controversial, mounting evidence from both clinical and animal studies have reported perioperative EA can improve cancer recurrence and survival many aspects, including modulating the immune/inflammation response and reducing the use of anesthetic agents like inhalation anesthetics and opioids, which are independent risk factors for cancer recurrence. However, these results depend on the cancer types, cancer staging, patients age, opioids use, and the duration of follow-up. This review will summarize the effects of perioperative EA on the oncological outcomes of patients after cancer surgery.
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This article was submitted to Surgical Oncology, a section of the journal Frontiers in Oncology
Reviewed by: Juan Chipollini, University of Arizona, United States; Zhi-Fu Wu, Kaohsiung Medical University, Taiwan
These authors have contributed equally to this work
Edited by: Oliver Kepp, INSERM U1138 Centre de Recherche des Cordeliers (CRC), France
ISSN:2234-943X
2234-943X
DOI:10.3389/fonc.2021.798435