Immunomodulatory effects of total intravenous and balanced inhalation anesthesia in patients with bladder cancer undergoing elective radical Cystectomy: preliminary results
| Autor: | Paola Cordiali Fei, Fabrizio Ensoli, Maria Elena Marcelli, Michele Gallucci, Ester Forastiere, Luana Fabrizi, Claudia Claroni, Maria Sofra |
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| Jazyk: | angličtina |
| Rok vydání: | 2013 |
| Předmět: |
Male
Cancer Research medicine.medical_specialty Urinary bladder carcinoma medicine.medical_treatment Total intravenous anesthesia with target-controlled infusion (TIVA-TCI) Tregs Cystectomy Gastroenterology lcsh:RC254-282 Proinflammatory cytokine Internal medicine Medicine Humans Bladder cancer business.industry Incidence (epidemiology) Research Cancer Interleukin Middle Aged medicine.disease lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens Balanced inhalation anesthesia (BAL) Oncology Urinary Bladder Neoplasms Anesthesia Anesthetic Anesthetics Inhalation Anesthesia Intravenous Cytokines Tumor necrosis factor alpha Female business Anesthesia Inhalation medicine.drug |
| Zdroj: | Journal of Experimental & Clinical Cancer Research, Vol 32, Iss 1, p 6 (2013) Journal of Experimental & Clinical Cancer Research : CR |
| ISSN: | 1756-9966 |
| Popis: | Background Although surgery and anesthesia induce immunesuppression, remains largely unknown whether various anesthetic techniques have different immunosuppressive effects on cancer patients. Therefore, the aim of this study was to investigate the influence of total intravenous anesthesia with target-controlled infusion (TIVA-TCI) and balanced inhalation anesthesia (BAL) on the peri-operative levels of inflammatory cytokines and regulatory T cells (Tregs) in patients with bladder cancer undergoing surgery. Methods Twenty eight consecutive patients with bladder cancer who underwent radical cystectomy were prospectively randomized into two groups to receive TIVA-TCI (n = 14) or BAL (n = 14). Before the induction of anesthesia (T0), 6–8 hours (T1) post-surgery, and 5 days post-surgery (T2), Tregs and serum levels of interleukin -1beta (IL-1β), interferon-gamma (IFN-γ), tumor necrosis factor-alpha (TNF-α), interleukin −2 (IL-2), interleukin −6 (IL-6), and interleukin −10 (IL-10) were measured. Results In the peri-operative period all cancer patients showed a marked and significant increase in IL-6. Moreover, TIVA-TCI patients also showed a higher increase in IFN-γ, whereas in BAL patients Tregs were reduced by approximately 30% during surgery. The incidence of infections, metastases, and death was similar in both groups. Conclusions The increase in the Th1 response in the TIVA-TCI group and the reduction in Tregs in the BAL group seem to balance the immunosuppressive effect induced by IL-6. Therefore TIVA-TCI and BAL can be both used in major surgery in patients with bladder cancer without worsening the outcome. |
| Databáze: | OpenAIRE |
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