scholarly journals The Role of General Anesthetic Drug Selection in Cancer Outcome

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Koichi Yuki
Keyword(s):  
Perioperative Care ◽  
Tumor Resection ◽  
Cancer Recurrence ◽  
Cancer Surgery ◽  
Drug Selection ◽  
General Anesthetic ◽  
Anesthetic Drug ◽  
Intravenous Anesthesia ◽  
Cancer Outcome

Cancer remains to be the leading cause of death globally. Surgery is a mainstay treatment for solid tumors. Thus, it is critical to optimize perioperative care. Anesthesia is a requisite component for surgical tumor resection, and general anesthesia is given in the vast majority of tumor resection cases. Because anesthetics are growingly recognized as immunomodulators, it is critical to optimize anesthetic regimens for cancer surgery if the selection can affect outcomes. Here, we reviewed the role of volatile and intravenous anesthesia used for cancer surgery in cancer recurrence.

Perioperative Care in Cancer Surgery

1987 ◽  
Vol 3 (3) ◽  
pp. 463-471
Author(s):  
Jerry C. Johnson
Keyword(s):  
Perioperative Care ◽  
Cancer Surgery

Opiophobia in Cancer Biology- Justified? - The Role of Perioperative Use of Opioids in Cancer Recurrence

2019 ◽  
Vol 25 (28) ◽  
pp. 3020-3027 ◽  
Author(s):  
Mir W. Sekandarzad ◽  
Chris Doornebal ◽  
Markus W. Hollmann
Keyword(s):  
Pain Management ◽  
Cancer Biology ◽  
Tumor Biology ◽  
Cancer Recurrence ◽  
Standard Of Care ◽  
Cancer Surgery ◽  
Perioperative Pain Management ◽  
Tumor Growth And Metastasis

: Opioids remain the standard of care in the provision of analgesia in the patient undergoing cancer surgery preoperatively. : The effects of opioids on tumor growth and metastasis have been discussed for many years. In recent years their use as part of the perioperative pain management bundle in the patients undergoing cancer surgery has been thought to promote cancer recurrence and metastasis. : This narrative review highlights earlier and more recent in vitro, in vivo and human retrospective studies that yield conflicting results as to the immune-modulatory effects of morphine on tumor biology. The article examines and explains the discrepancies with regards to the seemingly opposite results of morphine in the tumor milieu. The results of both, earlier studies that demonstrated procarcinogenic effects versus the data of more recent refined rodent studies that yielded neutral or even anti-carcinogenic effects are presented here. : Until the results of prospective randomized controlled trials are available to clarify this important question, it is currently not warranted to support opiophobia and opioids continue to constitute a pivotal role in the pain management of cancer patients.

scholarly journals Extradural anterior clinoidectomy in surgical management of clinoidal meningiomas

2021 ◽  
Vol 57 (1) ◽  
Author(s):  
K. El-Bahy ◽  
Ashraf M. Ibrahim ◽  
Ibrahim Abdelmohsen ◽  
Hatem A. Sabry
Keyword(s):  
Cavernous Sinus ◽  
Tumor Resection ◽  
Visual Outcome ◽  
Extent Of Resection ◽  
Optic Canal ◽  
Falciform Ligament ◽  
Cavernous Sinus Invasion ◽  
Anterior Clinoidectomy ◽  
Microsurgical Techniques

Abstract Background Despite the recent advances in skull base surgery, microsurgical techniques, and neuroimaging, yet surgical resection of clinoidal meningiomas is still a major challenge. In this study, we present our institution experience in the surgical treatment of anterior clinoidal meningiomas highlighting the role of extradural anterior clinoidectomy in improving the visual outcome and the extent of tumor resection. This is a prospective observational study conducted on 33 consecutive patients with clinoidal meningiomas. The surgical approach utilized consisted of extradural anterior clinoidectomy, optic canal deroofing with falciform ligament opening in all patients. The primary outcome assessment was visual improvement and secondary outcomes were extent of tumor resection, recurrence, and postoperative complications. Results The study included 5 males and 28 females with mean age 49.48 ± 11.41 years. Preoperative visual deficit was present in 30 (90.9%) patients. Optic canal involvement was present in 24 (72.7%) patients, ICA encasement was in 16 (48.5%), and cavernous sinus invasion in 8 (24.2%). Vision improved in 21 patients (70%), while 6 patients (20%) had stationary course and 1 patient (3%) suffered postoperative new visual deterioration. Gross total resection was achieved in 24 patients (72.7%). The main factors precluding total removal were cavernous sinus involvement and ICA encasement. Mortality rate was 6.1%; mean follow-up period was 27 ± 13 months. Conclusions In this series, the use of extradural anterior clinoidectomy provided a favorable visual outcome and improved the extent of resection in clinoidal meningioma patients.

scholarly journals Complex Bone Tumors of the Trunk—The Role of 3D Printing and Navigation in Tumor Orthopedics: A Case Series and Review of the Literature

2021 ◽  
Vol 11 (6) ◽  
pp. 517
Author(s):  
Martin Schulze ◽  
Georg Gosheger ◽  
Sebastian Bockholt ◽  
Marieke De Vaal ◽  
Tymo Budny ◽  
...  
Keyword(s):  
3D Printing ◽  
Tumor Resection ◽  
Case Series ◽  
Main Process ◽  
Patient Centered ◽  
Individual Care ◽  
Real Time Visualization ◽  
Bone Tumor Resection ◽  
Virtual Modeling

The combination of 3D printing and navigation promises improvements in surgical procedures and outcomes for complex bone tumor resection of the trunk, but its features have rarely been described in the literature. Five patients with trunk tumors were surgically treated in our institution using a combination of 3D printing and navigation. The main process includes segmentation, virtual modeling and build preparation, as well as quality assessment. Tumor resection was performed with navigated instruments. Preoperative planning supported clear margin multiplanar resections with intraoperatively adaptable real-time visualization of navigated instruments. The follow-up ranged from 2–15 months with a good functional result. The present results and the review of the current literature reflect the trend and the diverse applications of 3D printing in the medical field. 3D printing at hospital sites is often not standardized, but regulatory aspects may serve as disincentives. However, 3D printing has an increasing impact on precision medicine, and we are convinced that our process represents a valuable contribution in the context of patient-centered individual care.

scholarly journals Levels of Circulating PD-L1 Are Decreased in Patients with Resectable Cholangiocarcinoma

2021 ◽  
Vol 22 (12) ◽  
pp. 6569
Author(s):  
Christoph Roderburg ◽  
Sven H. Loosen ◽  
Jan Bednarsch ◽  
Patrick H. Alizai ◽  
Anjali A. Roeth ◽  
...  
Keyword(s):  
Tumor Recurrence ◽  
Tumor Biology ◽  
Tumor Resection ◽  
Postoperative Outcome ◽  
Serum Levels ◽  
Strong Trend ◽  
Programmed Cell Death 1 ◽  
Early Tumor ◽  
Circulating Levels

Tumor resection represents the only curative treatment option for patients with biliary tract cancers (BTCs), including intrahepatic cholangiocarcinoma (CCA), perihilar and extrahepatic CCA and gallbladder cancer. However, many patients develop early tumor recurrence and are unlikely to benefit from surgery. Therefore, markers to identify ideal surgical candidates are urgently needed. Circulating programmed cell death 1 ligand 1 (PD-L1) has recently been associated with different malignancies, including pancreatic cancer which closely resembles BTC in terms of patients’ prognosis and tumor biology. Here, we aim at evaluating a potential role of circulating PD-L1 as a novel biomarker for resectable BTC. Methods: Serum levels of PD-L1 were analyzed by ELISA in 73 BTC patients and 42 healthy controls. Results: Circulating levels of preoperative PD-L1 were significantly lower in patients with BTC compared to controls. Patients with low PD-L1 levels displayed a strong trend towards an impaired prognosis, and circulating PD-L1 was negatively correlated with experimental markers of promalignant tumor characteristics such as CCL1, CCL21, CCL25 and CCL26. For 37 out of 73 patients, postoperative PD-L1 levels were available. Interestingly, after tumor resection, circulating PD-L1 raised to almost normal levels. Notably, patients with further decreasing PD-L1 concentrations after surgery showed a trend towards an impaired postoperative outcome. Conclusion: Circulating PD-L1 levels were decreased in patients with resectable BTC. Lack of normalization of PD-L1 levels after surgery might identify patients at high risk for tumor recurrence or adverse outcome.

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