• Cancer immune
• Cytotoxic T-cell
• Morphine
• Natural killer cell
• Pancreatectomy
• Thoracic epidural analgesia

• Humans
• Male
• Female
• Analgesia, Epidural/methods
• Middle Aged
• Pancreatectomy
• Aged
• Analgesia, Patient-Controlled
• Pain, Postoperative/drug therapy
• Pancreatic Neoplasms/surgery
• Pancreatic Neoplasms/immunology
• Killer Cells, Natural/immunology
• Analgesics, Opioid/administration & dosage
• Analgesics, Opioid/therapeutic use
• Adult
• Dendritic Cells/immunology
• T-Lymphocytes, Regulatory/immunology
• Administration, Intravenous

• anesthesia
• cancer recurrence
• metastasis
• perioperative care

• (No. 2021R1G1A1014702). National Research Foundation of Korea (NRF) grant funded by the Korea government (MSIT; Ministry of Science and ICT)

• buprenorphine
• butorphanol
• cancer pain
• fentanyl
• immune effects
• methadone
• morphine
• opioids
• tramadol
• tumor cells

• Doi:10.54499/UIDB/00772/2020 projects UIDB/00772/2020 (Doi:10.54499/UIDB/00772/2020) funded by the Portuguese Foundation for Science and Technology (FCT).

• epidural anaesthesia
• general anaesthesia
• patient-reported outcome measures
• perioperative care
• spinal anaesthesia

• Humans
• Anesthesia, Epidural/methods
• Anesthesia, Spinal/methods
• Postoperative Complications/prevention & control
• Adult
• Surgical Procedures, Operative/methods
• Surgical Procedures, Operative/adverse effects
• Perioperative Care/methods
• Treatment Outcome

• Cancer
• Lidocaine
• Local anesthesia
• Surgery
• Survival
• Tumor microenvironment

• Humans
• Lidocaine/therapeutic use
• Lidocaine/pharmacology
• Neoplasms/drug therapy
• Neoplasms/pathology
• Anesthetics, Local/therapeutic use
• Anesthetics, Local/pharmacology
• Anesthetics, Local/administration & dosage
• Animals
• Disease Progression
• Tumor Microenvironment/drug effects
• Antineoplastic Agents/therapeutic use
• Antineoplastic Agents/pharmacology

• R01 CA250412 NCI NIH HHS
• R01 CA251545 NCI NIH HHS
• R01 EB029596 NIBIB NIH HHS
• R37 CA248018 NCI NIH HHS

• Hybrid anesthesia
• Total intravenous anesthesia
• Volatile anesthesia

• Humans
• Anesthetics, Inhalation/administration & dosage
• COVID-19/prevention & control
• Propofol/administration & dosage
• Anesthetics, Intravenous/administration & dosage
• Anesthesia, Intravenous/methods
• Anesthesia, Inhalation/methods

• Cancer
• immunity
• local anesthetics
• stress

• Humans
• Anesthetics, Local/therapeutic use
• Prospective Studies
• Retrospective Studies
• Antineoplastic Agents/therapeutic use
• Neoplasms/drug therapy

• Female
• Humans
• Analgesia
• Anesthesia, Conduction
• Breast Neoplasms/drug therapy
• Breast Neoplasms/surgery
• Neoplasm Recurrence, Local/prevention & control
• Pain Management
• Pain, Postoperative
• Clinical Trials as Topic

• cancer hallmarks
• cell mediated immunity
• natural killer cells
• tumor dormancy
• tumor microenvironment
• survival outcomes
• sympathetic nervous system

• Humans
• Anesthesia
• Lymph Node Excision
• Melanoma/pathology
• Neoplasm Recurrence, Local/surgery
• Sentinel Lymph Node Biopsy/methods
• Skin Neoplasms/pathology
• Tumor Microenvironment

• P30 CA016056 NCI NIH HHS

• general anaesthesia
• intravenous anaesthesia
• metastasis cancer
• opioid cancer
• postoperative analgesia
• recurrence cancer
• regional analgesia
• surgery

• Humans
• Neoplasm Recurrence, Local
• Anesthesia/methods
• Anesthetics/adverse effects
• Analgesics/adverse effects

• anesthetic drugs
• immune function
• immunotherapy
• microenvironment
• targeted therapy

• Humans
• Anesthetics/pharmacology
• Isoflurane
• Bibliometrics
• Anesthesia, General
• Immunity

• funding

• Abdominal cancer
• Cancer recurrence
• Overall survival
• regional anesthesia and analgesia

• aged
• cancer surgery
• inhalation anaesthesia
• intravenous anaesthesia
• morbidity
• propofol
• sevoflurane
• survival

• Propofol/adverse effects
• Sevoflurane/adverse effects
• Neoplasms/surgery
• Humans
• Male
• Female
• Aged
• Follow-Up Studies
• Anesthetics, Intravenous
• Anesthesia, Inhalation
• Cancer Survivors

• Female
• Humans
• Breast Neoplasms/drug therapy
• Breast Neoplasms/surgery
• Anesthetics, Local/therapeutic use
• Anesthesia, Local
• Neoplasm Recurrence, Local/drug therapy
• Disease-Free Survival
• Lidocaine
• Chemotherapy, Adjuvant

• Bladder cancer
• General anesthesia
• Meta-analysis
• Recurrence
• Regional anesthesia

• General anesthesia
• Recurrence
• Regional anesthesia
• Survival
• Tumor

• anesthesia
• cancer surgery
• tumor microenvironment
• tumor necrosis factor alpha

• Postoperative outcome
• enhanced recovery after surgery
• head and neck surgery
• postoperative complication

The non-muscle-invasive bladder cancer is a common malignancy of the urinary system. Many patients relapse after transurethral resection surgery. Different anaesthesia techniques may influence a patient’s immune system during the perioperative time. In this study, we examined the effects of different anaesthesia techniques on the prognosis of primary non-muscle-invasive bladder cancer after transurethral resection surgery.

In the period 2008 to 2017, a total of 926 patients suffered primary non-muscle-invasive bladder and underwent transurethral resection of bladder tumour surgery for the first time. These patients were divided into two groups according to the techniques that were used. There were 662 patients in the general anaesthesia group, who received propofol, opioid drugs (fentanyl family), non-depolarizing muscle relaxants, and sevoflurane, and 264 patients in the epidural anaesthesia group, who had an epidural catheter placed in the L2-L3 or L3-L4 interspace with a combination of lidocaine and ropivacaine or bupivacaine. We analyzed the influence factors that might affect prognosis and compared the recurrence-free survival time and the progression between the two groups.

The differences between the two groups in recurrence rate and progression rate were not statistically significant. Progression-free survival time of the epidural anaesthesia group was longer. Multivariate regression analysis showed that anaesthesia techniques were not independent influencing factors for recurrence and progression.

It was not found that anaesthesia techniques affected the recurrence or progression of patients with primary non-muscle-invasive bladder cancer after transurethral resection of bladder tumour.

• Epidural anaesthesia
• General anaesthesia
• Primary non-muscle-invasive bladder cancer
• Progression
• Recurrence-free survival time

Cancer is a leading cause of death, and surgery is an important treatment modality. Laboratory research and retrospective studies have raised the suspicion that the choice of anesthetics for cancer surgery might affect the course of cancerous disease. The aim of this review is to provide a critical overview of the current state of knowledge. Inhalational anesthesia with volatiles or total intravenous anesthesia (TIVA) with propofol are the two most commonly used anesthetic techniques. Most data comparing volatile anesthetics with TIVA is from either in vitro or retrospective studies. Although conflicting, data shows a trend towards favoring propofol. Opioids are commonly used in anesthesia. Data on potential effects of opioids on growth and recurrence of cancer are scarce and conflicting. Preclinical studies have shown that opioids stimulate cancer growth through the µ-opioid receptor. Opioids also act as immunosuppressants and, therefore, have the potential to facilitate metastatic spread. However, the finding of an adverse effect of opioids on tumor growth and cancer recurrence by some retrospective studies has not been confirmed by prospective studies. Regional anesthesia has not been found to have a beneficial effect on the outcome of surgically treated cancer patients, but prospective studies are scarce. Local anesthetics might have a beneficial effect, as observed in animal and in vitro studies. However, prospective clinical studies strongly question such an effect. Blood products, which may be needed during extensive cancer surgery suppress the immune system, and data strongly suggest a negative impact on cancer recurrence. The potential effects of other commonly used anesthetic agents on the outcome of cancer patients have not been sufficiently studied for drawing valid conclusions. In conclusion, laboratory data and most retrospective studies suggest a potential advantage of TIVA over inhalational anesthesia on the outcome of surgical cancer patients, but prospective, randomized studies are missing. Given the state of weak scientific evidence, TIVA may be used as the preferred type of anesthesia unless there is an individual contraindication against it. Studies on the effects of other drugs frequently used in anesthesia are limited in number and quality, and have found conflicting results.

• anesthetic technique
• angiogenesis
• immunosuppression
• inflammation
• oncologic surgery
• tumor recurrence and metastasis

• cancer
• cell death
• immunity
• local anesthetics
• surgery

Whether epidural anesthesia and analgesia (EA) is beneficial for postoperative cancer outcomes remains controversial and we conducted this historical cohort study to evaluate the association between EA and long-term outcomes following surgery for renal cell carcinoma (RCC). We collected patients receiving RCC surgery from 2011 to 2017 and followed up them until February 2020. Patient attributes, surgical factors and pathological features were gathered through electronic medical chart review. The association between EA and recurrence-free and overall survival after surgery was evaluated using Cox regression models with inverse probability of treatment weighting (IPTW) to balance the observed covariates. The median follow-up time for the 725 included patients was 50 months (interquartile range: 25.3–66.5) and 145 of them (20%) received perioperative EA. We demonstrated EA use was associated with better recurrence-free survival [IPTW adjusted hazard ratio (HR): 0.64, 95% confidence interval (CI): 0.49–0.83, p < 0.001] and overall survival [IPTW adjusted HR: 0.66, 95% CI: 0.49–0.89, p = 0.006] in patients receiving surgical resection for RCC. More prospective studies are needed to verify this connection between EA and superior cancer outcomes after RCC surgery.

• epidural analgesia
• inverse probability of treatment weighting
• recurrence
• renal cell carcinoma
• 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 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 via 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.

• cancer recurrence
• cancer surgeries
• cancer survival
• epidural analgesia
• oncological outcomes

Opioids are administered to cancer patients in the period surrounding tumour excision, and in the management of cancer-associated pain. The effects of opioids on tumour growth and metastasis, and their consequences on disease outcome, continue to be the object of polarised, discrepant literature. It is becoming clear that opioids contribute a range of direct and indirect effects to the biology of solid tumours, to the anticancer immune response, inflammation, angiogenesis and importantly, to the tumour-promoting effects of pain. A common misconception in the literature is that the effect of opioid agonists equates the effect of the mu-opioid receptor, the major target of the analgesic effect of this class of drugs. We review the evidence on opioid receptor expression in cancer, opioid receptor polymorphisms and cancer outcome, the effect of opioid antagonists, especially the peripheral antagonist methylnaltrexone, and lastly, the evidence available of a role for opioids through non-opioid receptor mediated actions.

• OGFr
• TLR4
• cancer
• metastasis
• opioid antagonist
• opioid receptor

Despite advances in cancer treatments, surgery remains one of the most important therapies for solid tumors. Unfortunately, surgery promotes angiogenesis, shedding of cancer cells into the circulation and suppresses anti-tumor immunity. Together this increases the risk of tumor metastasis, accelerated growth of pre-existing micro-metastasis and cancer recurrence. It was theorized that regional anesthesia could influence long-term outcomes after cancer surgery, however new clinical evidence demonstrates that the anesthesia technique has little influence in oncologic outcomes. Several randomized controlled trials are in progress and may provide a better understanding on how volatile and intravenous hypnotics impact cancer progression. The purpose of this review is to summarize the effect of the anesthesia techniques on the immune system and tumor microenvironment (TME) as well as to summarize the clinical evidence of anesthesia techniques on cancer outcomes.

• analgesia
• anesthesia
• cancer recurrence
• general anesthesia (GA)
• metastasis
• opioids
• regional anesthesia - palliative care - cancer pain
• total intravenous anaesthesia (TIVA)

Spontaneous ventilation video-assisted thoracoscopic surgery (SV-VATS) exhibits dual intraoperative and postoperative advantages for patients with non-small cell lung cancer (NSCLC). However, there is a lack of data regarding its long-term survival superiority over the double-lumen intubated mechanical ventilation video-assisted thoracoscopic surgery (MV-VATS) or thoracotomy.

A retrospective study was conducted from 2011 to 2018 in the First Affiliated Hospital of Guangzhou Medical University among patients with NSCLC who underwent the SV-VATS or the MV-VATS. Patients receiving the SV-VATS were the study group, and patients receiving the MV-VATS were the control group. Propensity score matching (PSM) was performed to establish 1:1 SV-VATS versus MV-VATS group matching to balance potential baseline confounding factors. Primary endpoints were overall survival (OS) and disease-free survival (DFS). Secondary endpoints were perioperative outcomes. The baseline information of these patients was recorded. The perioperative data and survival data were collected using a combination of electronic data record system and telephone interview. A 1:1:1 SPM was also used to compare the OS in the SV-VATS, the MV-VATS and thoracotomy group by using another database, including patients undergoing thoracotomy and the MV-VATS.

For the two-group comparison, after 1:1 PSM, a matched cohort with 400 (200:200) patients was generated. The median follow-up time in this cohort was 4.78 years (IQR, 3.78–6.62 years). The OS (HR =0.567, 95% CI, 0.330 to 0.974, P=0.0498) and the DFS (HR =0.546, 95% CI, 0.346 to 0.863, P=0.013) of the SV-VATS group were significantly better than the MV-VATS group. There were no statistically differences between the SV-VATS and the MV-VATS group on the operative time (158.56±40.09 vs. 172.06±61.75, P=0.200) anesthesia time (247.4±62.49 vs. 256.7±58.52, P=0.528), and intraoperative bleeding volume (78.88±80.25 vs. 109.932±180.86, P=0.092). For the three-group comparison, after 1:1:1 PSM, 582 (194:194:194) patients were included for the comparison of SV-VATS, MV-VATS and thoracotomy. The OS of the SV-VATS group was significantly better than the thoracotomy group (HR =0.379, 95% CI, 0.233 to 0.617, P<0.001).

Invasive NSCLC patients undergoing SV-VATS lobectomy demonstrated better long-term outcomes compared with MV-VATS.

• Spontaneous ventilation video-assisted thoracoscopic surgery (SV-VATS)
• lobectomy
• long-term survival
• mechanical ventilation video-assisted thoracoscopic surgery (MV-VATS)
• non-small cell lung cancer (NSCLC)

• anesthesia
• neoplasm
• progression
• survival

• regional anesthesia
• general anesthesia
• cancer recurrence
• systematic review
• meta-analysis

• Anesthesia, Conduction
• Humans
• Neoplasms
• Recurrence

Background: In patients with prostatic and breast cancer the application of peridural anesthesia (PDA) showed a beneficial effect on prognosis. This was explained by reduced requirements for general anesthetics and perioperative opioids as well as a lower perioperative stress level. The impact of PDA in patients with more aggressive types of cancer has not been completely elucidated. Here, we analyzed the prognostic influence of PDA on overall survival after surgery as primary in patients that underwent radical resection of pancreatic adenocarcinoma. Methods: Records of 98 consecutive patients were reviewed. In 70 of these cases PDA was applied. Patient characteristics such as demographics, TNM stage, and operative data were retrospectively collected from medical records and analyzed. Survival data were analyzed by Cox’s proportional hazard regression model. Results: Overall, no significant prognostic influence of PDA on recurrence or overall survival (p = 0.762, Hazard Ratio [HR] 0.884, 95% confidence interval [CI] 0.398–1.961) was found. However, there was a trend towards a longer overall survival (p = 0.069, HR 0.394, 95% CI 0.144–1.078) associated with PDA in a subgroup of patients with better differentiation of pancreatic adenocarcinoma. Conclusion: The observation of longer survival associated with PDA in our subgroup of patients with better-differentiated pancreatic carcinomas is in line with previous reports on various other less aggressive tumor entities. Our results indicate that PDA might improve the oncological outcome of patients with pancreatic adenocarcinoma.

• oncological outcome
• pancreatic adenocarcinoma
• recurrence
• staging

• Aged
• Aged, 80 and over
• Female
• Humans
• Male
• Middle Aged
• Analgesia, Epidural/methods
• Analgesia, Epidural/mortality
• Anesthesia, General/methods
• Anesthesia, General/mortality
• China/epidemiology
• Drug Therapy, Combination
• Follow-Up Studies
• Geriatric Assessment/methods
• Geriatric Assessment/statistics & numerical data
• Incidence
• Surgical Procedures, Operative/mortality
• Survival

• Chemotherapy
• neoplasm recurrence
• postoperative care
• radiation oncology
• regional anesthesia
• surgical oncology

• Anesthesia
• Anesthetics
• Cancer
• Neoplasms
• Postoperative period
• Surgery

• Aged
• Anesthesia, General
• Anesthetics, Inhalation
• Humans
• Neoplasms/epidemiology
• Neoplasms/surgery
• Propofol
• Retrospective Studies

• Analgesia
• NSCLC
• cancer
• opioids
• peridural
• recurrence
• thoracic surgery

Epidural analgesia (EA) has been the standard of care after major abdominal surgery for many years. This study aimed to correlate EA with postoperative complications, short- and long-term mortality in patients with and without EA after open surgery (OS) and minimally invasive surgery (MIS) for colorectal cancer.

Patient, clinical and outcome data were obtained from the Swedish Colorectal Cancer Registry and the Swedish Perioperative Registry. All adult patients diagnosed with colorectal cancer without metastases who underwent elective curative MIS or OS for colorectal cancer between January 2016 and December 2018 and who had data recorded in both registries, were included in the study. Data were analyzed for OS and MIS procedures separately. A Poisson regression model was used to investigate the association between EA and the outcomes of interest.

Five thousand seven hundred sixty-two patients were included in the study, 2712 in the MIS and 3050 patients in the OS group. After adjusting for patient specific and clinically relevant variables in the regression model, no statistically significant difference in risk for complications; 30-day, 90-day, and up to 3-year mortality following either MIS or OS could be detected between the EA+ and EA-cohorts.

In this large study cohort, EA as part of the comprehensive care provided was not associated with a reduction in postoperative complications risk or improved 30-day, 90-day, or 3-year survival after MIS or OS for colorectal cancer.

•

No reduction in postoperative complications with epidural analgesia.

• Colorectal cancer
• Epidural analgesia
• Minimally invasive surgery
• Mortality
• Open surgery

• analgesia
• cancer recurrence
• disease-free survival
• epidural anaesthesia
• opioid
• volatile anaesthesia

Thoracic epidural analgesia (TEA) has been suggested to improve survival after curative surgery for colorectal cancer compared with systemic opioid analgesia. The evidence, exclusively based on retrospective studies, is contradictory.

In this prospective, multicentre study, patients scheduled for elective colorectal cancer surgery between June 2011 and May 2017 were randomised to TEA or patient-controlled i.v. analgesia (PCA) with morphine. The primary endpoint was disease-free survival at 5 yr after surgery. Secondary outcomes were postoperative pain, complications, length of stay (LOS) at the hospital, and first return to intended oncologic therapy (RIOT).

We enrolled 221 (110 TEA and 111 PCA) patients in the study, and 180 (89 TEA and 91 PCA) were included in the primary outcome. Disease-free survival at 5 yr was 76% in the TEA group and 69% in the PCA group; unadjusted hazard ratio (HR): 1.31 (95% confidence interval [CI]: 0.74–2.32), P=0.35; adjusted HR: 1.19 (95% CI: 0.61–2.31), P=0.61. Patients in the TEA group had significantly better pain relief during the first 24 h, but not thereafter, in open and minimally invasive procedures. There were no differences in postoperative complications, LOS, or RIOT between the groups.

There was no significant difference between the TEA and PCA groups in disease-free survival at 5 yr in patients undergoing surgery for colorectal cancer. Other than a reduction in postoperative pain during the first 24 h after surgery, no other differences were found between TEA compared with i.v. PCA with morphine.

• colorectal cancer
• disease-free survival
• minimally invasive surgery
• open surgery
• patient-controlled intravenous analgesia
• recurrence
• thoracic epidural analgesia

The perioperative use of regional anesthesia and local anesthetics is part of almost every anesthesiologist’s daily clinical practice. Retrospective analyses and results from experimental studies pointed towards a potential beneficial effect of the local anesthetics regarding outcome—i.e., overall and/or recurrence-free survival—in patients undergoing cancer surgery. The perioperative period, where the anesthesiologist is responsible for the patients, might be crucial for the further course of the disease, as circulating tumor cells (shed from the primary tumor into the patient’s bloodstream) might form new micro-metastases independent of complete tumor removal. Due to their strong anti-inflammatory properties, local anesthetics might have a certain impact on these circulating tumor cells, either via direct or indirect measures, for example via blunting the inflammatory stress response as induced by the surgical stimulus. This narrative review highlights the foundation of these principles, features recent experimental and clinical data and provides an outlook regarding current and potential future research activities.

• cancer
• inflammation
• local anesthetics
• metastasis
• recurrence

• cancer recurrence
• onco-anaesthesia
• peri-operative medicine
• regional anaesthesia

• anaesthesia
• analgesia
• cancer recurrence
• paediatric
• regional techniques

• Adult
• Anesthesia, Epidural
• Anesthesia, General
• Anesthetics
• Child
• Humans
• Neoplasm Recurrence, Local
• Retrospective Studies

• anaesthesia in oncology
• colorectal surgery
• gastrointestinal tumours
• pain management

• Analgesia, Epidural
• Cohort Studies
• Colonic Neoplasms/surgery
• Humans
• Neoplasm Recurrence, Local/epidemiology
• Prognosis
• Retrospective Studies
• Taiwan/epidemiology

• Yen Tjing Ling Medical Foundation
• Anesthesiology Research and Development Foundation
• Department of Biotechnology, Ministry of Science and Technology
• Taipei Veterans General Hospital

Whether anesthesia methods affect the prognosis of tumor patients is controversial. With the aim of comparing the effects of general anesthesia (GA) and local anesthesia (LA) in primary hepatocellular carcinoma (HCC) patients presenting for elective thermal ablation (TA) surgeries, a multiple center retrospective cohort study was designed and implemented.

Patients who received elective TA surgery under GA or LA from Jan. 2014 to Dec. 2016 and met the eligibility criteria were included. Survival analysis was used to identify the influence of anesthesia methods on recurrence-free survival (RFS) and overall survival (OS). Propensity score matching (PSM) was used to minimize the bias between the GA group and the LA group.

A total of 244 patients with GA and 245 with LA were eligible for analysis. After PSM, 178 patients remained in each group. In the matched groups, GA showed a significantly higher recurrence rate compared with LA by both the Kaplan-Meier survival analyses (P=0.011) and multivariable Cox regression analyses (P=0.002). The multivariable Cox regression model also revealed that GA had a hazard ratio (HR) of 1.746 (P=0.036) for death compared with the LA group.

GA is associated with decreased RFS and OS after surgery compared with LA in HCC patients undergoing TA surgery. Prospective trials exploring the effects of different anesthetic methods on cancer outcome in these patients are warranted.

• Hepatocellular carcinoma (HCC)
• anesthesia methods
• propensity score matching (PSM)
• recurrence-free survival (RFS)
• thermal ablation (TA)

The aim of this study was to test the hypothesis that the use of inhalational anesthesia leads to higher suppression of the cell-mediated immunity compared to total intravenous anesthesia in patients undergoing kidney cancer surgery under combined low thoracic epidural analgesia and general anesthesia.

Patients were randomly allocated to either propofol-based (intravenous anesthetic) or sevoflurane-based (volatile anesthetic) anesthesia group with 10 patients in each group, along with epidural analgesia in both groups. Amounts of natural killer (NK) cells, total T lymphocytes, and T lymphocyte subpopulations in the blood samples collected from the patients before surgery, at the end of the surgery and postoperative days 1, 3 and 7 were determined by flow cytometric analysis. The NK cell count served as the primary endpoint of the study, whereas the total T lymphocyte count and cell counts for T lymphocyte subpopulations were used as the secondary endpoint.

Our study showed that there were no significant differences in the amount of NK cells, total T lymphocytes, regulatory T cells, and T-helper cells, cytotoxic T lymphocytes, and their subpopulations between the propofol- and sevoflurane-based anesthesia groups when the anesthesia was administered in combination with epidural analgesia.

The results of this pilot study did not support the hypothesis that the use of inhalational anesthesia leads to higher suppression of the cell-mediated immunity than that of total intravenous anesthesia in patients undergoing kidney cancer surgery under combined low thoracic epidural analgesia and general anesthesia.

• Anesthesia
• Cancer
• Epidural analgesia
• Immunity
• Propofol
• Sevoflurane