TY - JOUR
T1 - Challenges in research related to perioperative cancer care and cancer outcomes
AU - Cata, Juan P.
AU - Kurz, Andrea
PY - 2013/12
Y1 - 2013/12
N2 - Surgery is one of the most commonly used treatments to attempt cure of early-stage and some late-stage solid tumours. Paradoxically, surgery itself and some of the medical interventions involved in the perioperative care of cancer patients may be associated with an increased chance of metastasis. Researchers and perioperative clinicians have studied the phenomenon of surgery-induced immunosuppression and postoperative cancer recurrence for several decades. Unfortunately, the translation of basic science research into human studies is not clear. Moreover, a recent proliferation of retrospective studies with conflicting results and significant limitations has not shed light on the understanding of whether regional anaesthesia, anti-inflammatory interventions or blockade of the sympathetic response improve survival after cancer surgery. Ultimately, randomised controlled trials are required to answer some of the questions raised by preclinical and retrospective studies; however, investigators face many challenges in conducting these trials. Unless sufficient funding is obtained and cooperative research is developed in the near future, clinicians will not know whether anticancer perioperative interventions are useful to improve cancer-related survivals.
AB - Surgery is one of the most commonly used treatments to attempt cure of early-stage and some late-stage solid tumours. Paradoxically, surgery itself and some of the medical interventions involved in the perioperative care of cancer patients may be associated with an increased chance of metastasis. Researchers and perioperative clinicians have studied the phenomenon of surgery-induced immunosuppression and postoperative cancer recurrence for several decades. Unfortunately, the translation of basic science research into human studies is not clear. Moreover, a recent proliferation of retrospective studies with conflicting results and significant limitations has not shed light on the understanding of whether regional anaesthesia, anti-inflammatory interventions or blockade of the sympathetic response improve survival after cancer surgery. Ultimately, randomised controlled trials are required to answer some of the questions raised by preclinical and retrospective studies; however, investigators face many challenges in conducting these trials. Unless sufficient funding is obtained and cooperative research is developed in the near future, clinicians will not know whether anticancer perioperative interventions are useful to improve cancer-related survivals.
KW - cancer
KW - clinical research
KW - perioperative medicine
KW - randomised control trial
UR - http://www.scopus.com/inward/record.url?scp=84888435943&partnerID=8YFLogxK
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U2 - 10.1016/j.bpa.2013.10.004
DO - 10.1016/j.bpa.2013.10.004
M3 - Review article
C2 - 24267551
AN - SCOPUS:84888435943
SN - 1521-6896
VL - 27
SP - 457
EP - 464
JO - Best Practice and Research: Clinical Anaesthesiology
JF - Best Practice and Research: Clinical Anaesthesiology
IS - 4
ER -