Arun F, Arun O. Impact of propofol on gastrointestinal cancer outcomes: A review of cellular behavior, growth, and metastasis. World J Clin Oncol 2025; 16(7): 104727 [DOI: 10.5306/wjco.v16.i7.104727]
Corresponding Author of This Article
Oguzhan Arun, MD, PhD, Professor, Department of Anesthesiology and Reanimation, Selcuk University Faculty of Medicine, Alaaddin Keykubat Kampus, Konya 42130, Türkiye. oguzarun@selcuk.edu.tr
Research Domain of This Article
Anesthesiology
Article-Type of This Article
Review
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Oncol. Jul 24, 2025; 16(7): 104727 Published online Jul 24, 2025. doi: 10.5306/wjco.v16.i7.104727
Impact of propofol on gastrointestinal cancer outcomes: A review of cellular behavior, growth, and metastasis
Funda Arun, Oguzhan Arun
Funda Arun, Division of Anesthesiology, Department of Pedodontics, Selcuk University Faculty of Dentistry, Konya 42130, Türkiye
Oguzhan Arun, Department of Anesthesiology and Reanimation, Selcuk University Faculty of Medicine, Konya 42130, Türkiye
Author contributions: Arun O reviewed the relevant literature, designed the concept and outline of this review, wrote, edited, and finalized the manuscript for publication; Arun F reviewed and provided critical review and edits to enhance the content.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Oguzhan Arun, MD, PhD, Professor, Department of Anesthesiology and Reanimation, Selcuk University Faculty of Medicine, Alaaddin Keykubat Kampus, Konya 42130, Türkiye. oguzarun@selcuk.edu.tr
Received: January 2, 2025 Revised: March 26, 2025 Accepted: June 10, 2025 Published online: July 24, 2025 Processing time: 204 Days and 13.3 Hours
Abstract
Cancer is one of the most important health problems that deeply affects all humanity and will have groundbreaking consequences in human history with its elimination. Gastrointestinal cancers, including colon and rectum, stomach, liver, pancreatic, and esophageal, account for 26% of the global cancer incidence and 35% of cancer-related deaths. Unfortunately, it is estimated that today’s high incidence and mortality rates will increase by 58% and 73% by 2040, respectively. Although the treatment process includes novel options such as immunotherapy in addition to classical options with a multidisciplinary approach, surgical treatment under general anesthesia remains the leading option. Considering a long-lasting cancer process, it is quite surprising that a very short-term anesthetic administration can have various effects on cancer cell behavior. Various anesthetic approaches such as regional blocks used in pain management, the use of anesthetic adjuvants such as β-adrenoceptor antagonists, nonsteroidal anti-inflammatory drugs, and intravenous lidocaine, and the choice of anesthetic drugs seem to have potential effects on long-term cancer outcomes. Propofol is an intravenous anesthetic drug that is used for both induction and maintenance of general anesthesia. Many in vitro and clinical studies examining the effects of propofol comparatively with other anesthetic agents on tumor recurrence and metastasis revealed possible effects on tumor cell signaling, the immune response, and the modulation of the neuroendocrine stress response. However, the evidence from all these in vitro and clinical studies is different, complicated, and inconsistent. The general effects of propofol on the behavioral patterns, growth, and metastasis of gastrointestinal tumor cells, as well as the clinical features and consequences resulting from these effects, constitute the subject of this review.
Core Tip: Gastrointestinal cancers pose a significant global health concern. Surgical resection under general anesthesia serves as the primary treatment for gastrointestinal cancers. The two main anesthesia techniques utilized in cancer surgery today are propofol-based total intravenous anesthesia and volatile agent-based inhaled anesthesia. The potential impacts of the selected anesthesia technique on cancer cells, their biological behavior, and the associated clinical outcomes are subjects of extensive experimental and clinical research. Due to the conflicting findings from these studies, it remains impossible to provide personalized anesthesia recommendations based on the type of cancer and the patient’s condition.
