[The perioperative period in cancer surgery: a critical moment! Is there a role for regional anesthesia in preventing cancer recurrence?].

Surgical treatment of cancer is usually necessary but it can paradoxically aggravate the patient outcome by increasing the risk of recurrence. Many perioperative factors have been shown to contribute to the dissemination of the tumor: surgery itself, stress, inflammation, pain, anaesthetic drugs, blood transfusion, etc. The type of anaesthesia chosen in the cancer patient could then be crucial and influence the evolution of the disease. Experimental, preclinical and retrospective studies have suggested that a regional anesthesia associated or not with a general anesthesia for carcinologic surgery might reduce the risk of cancer recurrence. This text reviews the factors promoting the recurrence of tumors after carcinologic surgery and the potential possibilities of protection associated with the type of anaesthesia chosen.

Beloeil H ，Nouette-Gaulain K 《-》

Does regional analgesia reduce the risk of cancer recurrence? A hypothesis.

Sessler DI 《-》

Review article: the role of the perioperative period in recurrence after cancer surgery.

Gottschalk A ，Sharma S ，Ford J ，Durieux ME ，Tiouririne M ... -  《-》

Can regional analgesia reduce the risk of recurrence after breast cancer? Methodology of a multicenter randomized trial.

Sessler DI ，Ben-Eliyahu S ，Mascha EJ ，Parat MO ，Buggy DJ ... -  《-》

Understanding clinical strategies that may impact tumour growth and metastatic spread at the time of cancer surgery.

The role of the perioperative period during cancer surgery and its impact on patients' long-term cancer outcomes are of increasing interest. Anticipation and prevention of perioperative immunosuppression and targeted therapeutic interventions that translate to reduced cancer recurrence are increasingly being explored. These interventions may focus on reducing the systemic inflammatory response, the regional lymphatic flow induced by surgical inflammation and exposure to perioperative immunosuppressive agents. The challenge has been to provide evidence-based links between these hypothesised cancer 'reducing' strategies, our knowledge of cancer biology and tangible long-term clinical outcomes of improved recurrence-free and overall survival. Anaesthesiologists caring for patients with cancer may preferentially employ regional anaesthesia techniques and anti-inflammatory agents to minimise perioperative immunosuppression and preserve perioperative homeostasis. However, prospective trials powered for long-term cancer outcomes are necessary to provide an evidence base before these strategies are to be recommended for routine clinical practice.

Hiller J ，Brodner G ，Gottschalk A 《-》