Topical Collection "Editorial Board Members’ Collection Series: Contemporary Perioperative Concepts in Cancer Surgery"

A topical collection in Current Oncology (ISSN 1718-7729). This collection belongs to the section "Surgical Oncology".

Editors

Prof. Dr. Vijaya Gottumukkala
E-Mail Website
Collection Editor
Department of Anesthesiology and Perioperative Medicine, UTMD Anderson Cancer Center, Houston, TX, USA
Interests: opioid analgesics; perioperative care; recurrence; anesthesia
Prof. Dr. Jörg Kleeff
E-Mail Website
Collection Editor
Department of Visceral, Vascular and Endocrine Surgery, University Hospital Halle (Saale), Ernst-Grube-Str. 40, 06120 Halle (Saale), Germany
Interests: abdominal surgery; radiation therapy; anesthesiology; hepatobiliary and pancreatic surgery
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Topical Collection Information

Dear Colleagues,

Cancer is a major global public health concern that affects all communities across the world. Globally, the incidence of cancer is predicted to increase by 50% by the year 2030; and during the same period, cancer-related mortality is projected to increase by 60% to 13.1 million deaths worldwide. This increasing trend in cancer-related mortality is mainly due to the increasing incidence of cancer and cancer-related mortality in the developing world and the overall increase in global population, particularly the marked increase in the population over the age of 60 years.

Of the nearly 20 million new cancer cases worldwide in 2022, over 80% of cases will need surgery, some several times, as curative resection is essential for cancer control, particularly for those with solid tumors. Given the emerging tsunami of cancer and increasing need for surgical cancer care; understanding advances in cancer biology, rapidly evolving cancer therapeutics, modern surgical techniques, and evolving patient-centered, recovery-focused perioperative care concepts is essential for anesthesiologists, perioperative clinicians, surgeons, nurses, intensivists, pain medicine clinicians and integrative medicine specialists.

The perioperative period is a pathophysiological state characterized by intense emotional and physiological (surgical) stress, pain, inflammation, immune suppression, negative nitrogen balance, and insulin resistance. The combined effect of neuro-inflammatory signaling and endocrine-metabolic effects in the perioperative period can lead to immune suppression and altered immune responses, influencing wound healing and recovery from surgery. However, these pathways are also an integral component of the inflammatory-immune responses leading to an immunosuppressive microenvironment in tumor stromal tissue, particularly in the presence of postoperative complications. Our understanding of perioperative factors that contribute to tumor spread and recurrence (from minimal residual disease, circulating tumor cells, or micro metastatic disease) is rapidly evolving with the potential to influence long-term cancer outcomes. In the surgical cancer patient, effective perioperative strategies and surgical techniques should, therefore, not only aim to provide effective analgesia and control of symptom burden, but also aim for margin free resection, minimize preventable complications and enhance functional recovery. Surgical techniques, operative approaches, and perioperative cancer therapies should also aim to attenuate the surgical stress response and positively modulate the inflammatory-immune response for improved clinical, oncological, and patient-centered outcomes.

This Topical Collection of Current Oncology titled “Contemporary Perioperative Concepts in Cancer Surgery” will address key topics of advances in cancer biology, newer cancer therapeutics, modern surgical techniques, and evolving patient-centered, recovery-focused perioperative care concepts that directly influence patient outcomes. Each of the articles is authored by international experts in the field and discusses the current understanding and practices, ongoing controversies and unanswered questions, and the direction for future studies. This exercise, we hope, will highlight the need for ongoing scientific study on key areas to further enhance perioperative and periprocedural care of our patients with cancer and cancer survivors.

Sincerely,

Prof. Dr. Vijaya Gottumukkala
Prof. Dr. Jörg Kleeff
Collection Editors

Manuscript Submission Information

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Keywords

  • advances in cancer biology
  • modern surgical techniques
  • perioperative care
  • anesthetic technique
  • pain management
  • rehabilitative and palliative care

Published Papers (1 paper)

2023

Review
Research in Perioperative Care of the Cancer Patient: Opportunities and Challenges
Curr. Oncol. 2023, 30(1), 1186-1195; https://doi.org/10.3390/curroncol30010091 - 15 Jan 2023
Viewed by 766
Abstract
The theory that the perioperative period is critical for oncological outcomes has been a matter of extensive preclinical and clinical research. Basic science research strongly supports the notion that surgical stress, anesthetics, and analgesics influence the mechanisms of cancer progression. Hence, it is [...] Read more.
The theory that the perioperative period is critical for oncological outcomes has been a matter of extensive preclinical and clinical research. Basic science research strongly supports the notion that surgical stress, anesthetics, and analgesics influence the mechanisms of cancer progression. Hence, it is hypothesized that perioperative interventions that impact mechanisms or predictors of tumor progression can also affect patients’ survival. As a result of that hypothesis, clinical researchers have conducted many retrospective studies. However, much fewer randomized controlled trials have been performed to investigate whether surgery itself (minimally invasive versus open procedures), anesthetics (volatile anesthetics versus propofol-based anesthesia), analgesics (opioids versus opioid-free anesthesia), and blood transfusions (transfusions versus no transfusions) modify the survival of patients with cancer. Unfortunately, randomized controlled trials have failed to translate the preclinical results into clinical outcomes. In this review, I will highlight the challenges of translating basic science to clinical outcomes. We will also point out opportunities for future research. Full article
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