Anaesthesia, analgesia, and cancer outcomes: Time to think like oncologists? Editorial
| Authors: | Mincer, J. S.; Buggy, D. J. |
| Title: | Anaesthesia, analgesia, and cancer outcomes: Time to think like oncologists? |
| Abstract: | Cao and colleagues present a follow-up analysis of a previous RCT among >1200 older adults (mean age 72 yr) undergoing cancer surgery, originally designed to evaluate the effect of propofol or sevoflurane general anaesthesia on delirium, here to evaluate the effect of anaesthetic technique on overall survival and recurrence-free survival. Neither anaesthetic technique conferred an advantage on oncological outcomes. We suggest that although it is entirely plausible that the observed results are truly robust neutral findings, the present study could be limited, like most published studies in the field, by its heterogeneity and understandable absence of underlying individual patient-specific tumour genomic data. We argue for a precision oncology approach to onco-anaesthesiology research that recognises that cancer is not one but rather many diseases and that tumour genomics (and multi-omics) is a fundamental determinant relating drugs to longer-term outcomes. © 2023 British Journal of Anaesthesia |
| Keywords: | cancer surgery; primary tumor; overall survival; recurrence risk; follow up; colorectal cancer; breast cancer; opiate; propofol; delirium; epidermal growth factor receptor 2; estrogen; recurrence; editorial; transcriptomics; tumor suppressor gene; lung adenocarcinoma; immune response; tumor recurrence; nonsteroid antiinflammatory agent; general anesthesia; immunomodulation; perioperative period; lidocaine; analgesia; beta adrenergic receptor blocking agent; recurrence free survival; clear cell renal cell carcinoma; non small cell lung cancer; tumor microenvironment; genomic mutation; high throughput sequencing; regional anesthesia; sevoflurane; cancer; human; anaesthesia; precision oncology; oncogenomics; multi-omics; mouse double minute 2 homolog; tumour genomics; beta adrenergic receptor blocking |
| Journal Title: | British Journal of Anaesthesia |
| Volume: | 131 |
| Issue: | 2 |
| ISSN: | 0007-0912 |
| Publisher: | Oxford University Press |
| Date Published: | 2023-08-01 |
| Start Page: | 193 |
| End Page: | 196 |
| Language: | English |
| DOI: | 10.1016/j.bja.2023.02.001 |
| PUBMED: | 36863979 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | The MSK Cancer Center Support Grant (P30 CA008748) is acknowledged in the PDF -- Corresponding author is MSK author: Joshua S. Mincer -- Source: Scopus |
