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Pancreatic Cancer and Microenvironments: Implications of Anesthesia

1
Department of Anesthesiology, Tri-Service General Hospital and National Defense Medical Center, Taipei 114, Taiwan
2
Department of Anesthesiology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan
3
Department of Anesthesiology, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
4
Center for Regional Anesthesia and Pain Medicine, Wan Fang Hospital, Taipei Medical University, Taipei 116, Taiwan
*
Author to whom correspondence should be addressed.
Academic Editor: Hideaki Ijichi
Cancers 2022, 14(11), 2684; https://doi.org/10.3390/cancers14112684
Received: 27 April 2022 / Revised: 25 May 2022 / Accepted: 25 May 2022 / Published: 28 May 2022
(This article belongs to the Special Issue Tumor Microenvironment and Pancreatic Cancer)
Pancreatic cancer is a lethal malignant neoplasm with less than 10% 5-year relative survival after the initial diagnosis. Several factors may be related to the poor prognosis of pancreatic cancer, including the rapid tumor progression, increased metastatic propensity, insignificant symptoms, shortage of early diagnostic biomarkers, and its tendency toward resistance to both chemotherapy and radiotherapy. Pancreatic neoplastic cells interact intimately with a complicated microenvironment that can foster drug resistance, metastasis, or relapse in pancreatic cancer. In addition, evidence shows that perioperative factors, including surgical manipulation, anesthetics, or analgesics, might alter the tumor microenvironment and cancer progression. This review outlines the up-to-date knowledge of anesthesia implications in the pancreatic microenvironment and provides future anesthetic strategies for improving pancreatic cancer survival.
Pancreatic malignancy is a lethal neoplasm, as well as one of the leading causes of cancer-associated mortality, having a 5-year overall survival rate of less than 10%. The average life expectancy of patients with advanced pancreatic cancer does not exceed six months. Although surgical excision is a favorable modality for long-term survival of pancreatic neoplasm, metastasis is initially identified in nearly 80% of the patients by the time of diagnosis, making the development of therapeutic policy for pancreatic cancer extremely daunting. Emerging evidence shows that pancreatic neoplastic cells interact intimately with a complicated microenvironment that can foster drug resistance, metastasis, or relapse in pancreatic cancer. As a result, the necessity of gaining further insight should be focused on the pancreatic microenvironment contributing to cancer progression. Numerous evidence reveals that perioperative factors, including surgical manipulation and anesthetics (e.g., propofol, volatile anesthetics, local anesthetics, epidural anesthesia/analgesia, midazolam), analgesics (e.g., opioids, non-steroidal anti-inflammatory drugs, tramadol), and anesthetic adjuvants (such as ketamine and dexmedetomidine), might alter the tumor microenvironment and cancer progression by affecting perioperative inflammatory or immune responses during cancer surgery. Therefore, the anesthesiologist plays an important role in perioperative management and may affect surgical outcomes. However, the literature on the impact of anesthesia on the pancreatic cancer microenvironment and progression is limited. This review summarizes the current knowledge of the implications of anesthesia in the pancreatic microenvironment and provides future anesthetic strategies for improving pancreatic cancer survival rates. View Full-Text
Keywords: pancreatic cancer; tumor microenvironment; anesthesia pancreatic cancer; tumor microenvironment; anesthesia
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MDPI and ACS Style

Lai, H.-C.; Kuo, Y.-W.; Huang, Y.-H.; Chan, S.-M.; Cheng, K.-I.; Wu, Z.-F. Pancreatic Cancer and Microenvironments: Implications of Anesthesia. Cancers 2022, 14, 2684. https://doi.org/10.3390/cancers14112684

AMA Style

Lai H-C, Kuo Y-W, Huang Y-H, Chan S-M, Cheng K-I, Wu Z-F. Pancreatic Cancer and Microenvironments: Implications of Anesthesia. Cancers. 2022; 14(11):2684. https://doi.org/10.3390/cancers14112684

Chicago/Turabian Style

Lai, Hou-Chuan, Yi-Wei Kuo, Yi-Hsuan Huang, Shun-Ming Chan, Kuang-I Cheng, and Zhi-Fu Wu. 2022. "Pancreatic Cancer and Microenvironments: Implications of Anesthesia" Cancers 14, no. 11: 2684. https://doi.org/10.3390/cancers14112684

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