The Role of Regional Anesthesia in Preventing Cancer Recurrence

区域麻醉在预防癌症复发中的作用

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Abstract

Surgical resection remains the main curative approach for many solid cancers; however, recurrence and metastasis continue to present major challenges. Anesthetic techniques during the perioperative period may influence tumor behavior through their effects on immune and stress pathways. Regional anesthesia (RA) has been proposed as a potential strategy to reduce postoperative recurrence by limiting neuroendocrine activation, decreasing opioid use, and possibly exerting direct antitumor effects. A literature review was conducted to examine studies evaluating the relationship between RA and oncologic outcomes. Screening and synthesis were performed independently by multiple reviewers. Included studies encompassed laboratory, retrospective, prospective, and randomized research exploring both biological mechanisms and clinical outcomes. Experimental findings suggest that RA may help preserve immune function, reduce inflammation, and inhibit tumor growth and angiogenesis. Early clinical studies indicated possible benefits in recurrence-free survival, though more recent large-scale research has not confirmed a clear reduction in recurrence or mortality. Overall, evidence remains inconsistent and influenced by heterogeneity across study designs and cancer types. Despite uncertain oncologic effects, RA continues to offer well-established perioperative benefits, including improved pain control, reduced opioid use, and faster recovery. Further large, tumor-specific, and mechanism-focused trials are needed to clarify any potential long-term impact on cancer outcomes.

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