Anesthetics and cancer biology: Translational evidence from perioperative modulation to drug repurposing (Review)
4 affiliations
- 1Department of Anesthesiology, The Affiliated Hospital of Southwest Jiaotong University, The Third People's Hospital of Chengdu, Chengdu, Sichuan 610031, P.R. China
- 2Department of Laboratory Medicine, Xindu District People's Hospital, Chengdu, Sichuan 610500, P.R. China
- 3Department of Cardiovascular Medicine, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan 646000, P.R. China
- 4Medical Research Center, The Affiliated Hospital of Southwest Jiaotong University, The Third People's Hospital of Chengdu, Chengdu, Sichuan 610031, P.R. China
Abstract
Perioperative anesthesia is delivered during a brief but biologically dynamic interval in which surgical stress, inflammation, immune perturbation and tissue repair may alter the environment encountered by residual or disseminated tumor cells. Experimental studies indicate that anesthetic-related agents can modify proliferation, apoptosis, epithelial-mesenchymal transition, angiogenesis, immune surveillance and the tumor microenvironment. Translation to clinical benefit, however, has been inconsistent, in part because experimental models, routes and exposure schedules often differ substantially from perioperative pharmacology. Lidocaine and propofol illustrate this gap. In early breast cancer, a multicenter randomized trial reported improved 5-year disease-free and overall survival after preoperative peritumoral infiltration with 0.5% lidocaine, although independent confirmation is still required. By contrast, randomized comparisons of propofol-based and volatile anesthesia, including long-term follow-up studies and GA-CARES, have not demonstrated an overall- or disease-free-survival advantage for propofol. Mechanistic and perioperative biomarker studies remain informative, but these biomarkers are not validated surrogates for oncological outcomes. This review therefore evaluates anesthetic-related interventions according to the exposure actually delivered, the level of mechanistic inference supported and the strength of clinical outcome evidence. Routine anesthetic choice should continue to follow established perioperative indications, whereas future cancer-directed studies should align clinically achievable exposure with defined biological mechanisms, selected patient populations and clinically meaningful endpoints.
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BibTeX
@article{yang2026anesthetics,
title = {{Anesthetics and cancer biology: Translational evidence from perioperative modulation to drug repurposing (Review)}},
author = {Ting Yang and Jiao Tang and Muhammad Saqib Mudabbar and Huan Hu and Qiang Fu and Chunlan Pu},
journal = {International Journal of Molecular Medicine},
year = {2026},
month = oct,
doi = {10.3892/ijmm.2026.6007},
url = {https://doi.org/10.3892/ijmm.2026.6007},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - Anesthetics and cancer biology: Translational evidence from perioperative modulation to drug repurposing (Review)
AU - Ting Yang
AU - Jiao Tang
AU - Muhammad Saqib Mudabbar
AU - Huan Hu
AU - Qiang Fu
AU - Chunlan Pu
PY - 2026
DA - 2026/10/05
JO - International Journal of Molecular Medicine
DO - 10.3892/ijmm.2026.6007
UR - https://doi.org/10.3892/ijmm.2026.6007
AB - Perioperative anesthesia is delivered during a brief but biologically dynamic interval in which surgical stress, inflammation, immune perturbation and tissue repair may alter the environment encountered by residual or disseminated tumor cells. Experimental studies indicate that anesthetic-related agents can modify proliferation, apoptosis, epithelial-mesenchymal transition, angiogenesis, immune surveillance and the tumor microenvironment. Translation to clinical benefit, however, has been inconsistent, in part because experimental models, routes and exposure schedules often differ substantially from perioperative pharmacology. Lidocaine and propofol illustrate this gap. In early breast cancer, a multicenter randomized trial reported improved 5-year disease-free and overall survival after preoperative peritumoral infiltration with 0.5% lidocaine, although independent confirmation is still required. By contrast, randomized comparisons of propofol-based and volatile anesthesia, including long-term follow-up studies and GA-CARES, have not demonstrated an overall- or disease-free-survival advantage for propofol. Mechanistic and perioperative biomarker studies remain informative, but these biomarkers are not validated surrogates for oncological outcomes. This review therefore evaluates anesthetic-related interventions according to the exposure actually delivered, the level of mechanistic inference supported and the strength of clinical outcome evidence. Routine anesthetic choice should continue to follow established perioperative indications, whereas future cancer-directed studies should align clinically achievable exposure with defined biological mechanisms, selected patient populations and clinically meaningful endpoints.
SN - 1107-3756
SN - 1791-244X
ER -