November 29, 2025
Background: It has been almost two decades since it was first hypothesized that anesthesia technique might modulate cancer biology and thus potentially influence patients’ long-term outcomes after cancer surgery. Since then, research efforts have been directed toward elucidating the potential pharmacological and physiological basis for the effects of anesthetic and perioperative interventions on cancer cell biology.
Review: Current laboratory and clinical data suggest that, although preclinical studies provide biologic plausibility that cancer cell function could be influenced by anesthetic and perioperative interventions, the available clinical evidence indicates a largely neutral effect. Observational studies examining cancer outcomes after curative surgery across many cancer types and anesthetic techniques have reported conflicting results, supporting the need for prospective randomized clinical trials (RCTs). Because such trials require large patient populations and prolonged follow-up, relatively few have been completed.
Conclusions: With the exception of peritumoral lidocaine infiltration in breast cancer surgery, completed randomized clinical trials have demonstrated a neutral effect of anesthetic technique on long-term oncologic outcomes. Unless significant new findings emerge from ongoing trials, future research should focus on how perioperative agents interact with tumor genes that influence metastatic potential. Strengthening multidisciplinary collaboration to optimize perioperative care for patients with cancer will also be important.
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