Volatile anaesthetics enhance the metastasis related cellular signalling including CXCR2 of ovarian cancer cells

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 Volatile anaesthetics at clinically relevant concentrations have strong effects on cancer cell biology which in turn could enhance ovarian cancer metastatic potential. This work raises the urgency for further in vivo studies and clinical trials before any conclusions can be made in term of the alteration of clinical practice.

INTRODUCTION

The death rate from ovarian cancer in the United States is more than double that of any other gynaecological malignancy [1, 2]. The poor prognosis is not only due to the aggressive nature of this disease but also because metastases are often present at the time of diagnosis or surgery [3]. It is thought that perioperative factors may contribute to cancer recurrence [4]. Surgical procedures such as biopsy and resection have been reported to disseminate cancer cells into the circulation and surrounding tissues [5] and many studies have reported that general anaesthesia dampens immune function, which is required to eliminate cancer cells [3, 6, 7].

The effect of general anaesthetics on healthy cells or tissues in the micro-environment have been investigated for many years and both volatile and intravenous agents have been shown to alter miRNA, mRNA and protein expressions [7, 8]. A variety of anaesthetics are used for cancer resection without their direct cellular effects on cancer cells being known. Recent clinical evidence has indicated that the choice of anaesthesia and application technique could potentially change the long-term prognosis of cancer patients. It has been shown that, compared to general anaesthesia, epidural anaesthesia for surgery to resect colonic cancer is associated with improved survival [9]. The latest study indicated an association between certain inhalational anesthetics and ovarian cancer outcomes [10] .....