Show simple item record

dc.contributor.authorHiller, JGen_US
dc.contributor.authorPerry, NJen_US
dc.contributor.authorPoulogiannis, Gen_US
dc.contributor.authorRiedel, Ben_US
dc.contributor.authorSloan, EKen_US
dc.date.accessioned2018-01-30T11:11:07Z
dc.date.issued2018-04en_US
dc.identifier.citationNature reviews. Clinical oncology, 2018, 15 (4), pp. 205 - 218en_US
dc.identifier.issn1759-4774en_US
dc.identifier.urihttps://repository.icr.ac.uk/handle/internal/1033
dc.identifier.eissn1759-4782en_US
dc.identifier.doi10.1038/nrclinonc.2017.194en_US
dc.description.abstractSurgery is a mainstay treatment for patients with solid tumours. However, despite surgical resection with a curative intent and numerous advances in the effectiveness of (neo)adjuvant therapies, metastatic disease remains common and carries a high risk of mortality. The biological perturbations that accompany the surgical stress response and the pharmacological effects of anaesthetic drugs, paradoxically, might also promote disease recurrence or the progression of metastatic disease. When cancer cells persist after surgery, either locally or at undiagnosed distant sites, neuroendocrine, immune, and metabolic pathways activated in response to surgery and/or anaesthesia might promote their survival and proliferation. A consequence of this effect is that minimal residual disease might then escape equilibrium and progress to metastatic disease. Herein, we discuss the most promising proposals for the refinement of perioperative care that might address these challenges. We outline the rationale and early evidence for the adaptation of anaesthetic techniques and the strategic use of anti-adrenergic, anti-inflammatory, and/or antithrombotic therapies. Many of these strategies are currently under evaluation in large-cohort trials and hold promise as affordable, readily available interventions that will improve the postoperative recurrence-free survival of patients with cancer.en_US
dc.formatPrint-Electronicen_US
dc.format.extent205 - 218en_US
dc.languageengen_US
dc.language.isoengen_US
dc.rights.urihttp://www.rioxx.net/licenses/under-embargo-all-rights-reserveden_US
dc.subjectHumansen_US
dc.subjectNeoplasmsen_US
dc.subjectNeoplasm Metastasisen_US
dc.subjectNeoplasm Recurrence, Localen_US
dc.subjectNeoplasm, Residualen_US
dc.subjectDisease Progressionen_US
dc.subjectAdrenergic Antagonistsen_US
dc.subjectAnti-Inflammatory Agentsen_US
dc.subjectFibrinolytic Agentsen_US
dc.subjectNeoadjuvant Therapyen_US
dc.subjectPerioperative Careen_US
dc.titlePerioperative events influence cancer recurrence risk after surgery.en_US
dc.typeJournal Article
rioxxterms.versionofrecord10.1038/nrclinonc.2017.194en_US
rioxxterms.licenseref.startdate2018-04en_US
rioxxterms.typeJournal Article/Reviewen_US
dc.relation.isPartOfNature reviews. Clinical oncologyen_US
pubs.issue4en_US
pubs.notesNot knownen_US
pubs.organisational-group/ICR
pubs.organisational-group/ICR/Primary Group
pubs.organisational-group/ICR/Primary Group/ICR Divisions
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Cancer Biology
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Cancer Biology/Signalling & Cancer Metabolism
pubs.organisational-group/ICR/Students
pubs.organisational-group/ICR/Students/PhD and MPhil
pubs.organisational-group/ICR/Students/PhD and MPhil/16/17 Starting Cohort
pubs.publication-statusPublisheden_US
pubs.volume15en_US
pubs.embargo.termsNot knownen_US
icr.researchteamSignalling & Cancer Metabolismen_US
dc.contributor.icrauthorPoulogiannis, Georgiosen_US
dc.contributor.icrauthorPerry, Nicholasen_US


Files in this item

Thumbnail

This item appears in the following Collection(s)

Show simple item record