Perioperative events influence cancer recurrence risk after surgery

Key Points Surgery remains the primary treatment for patients with solid tumours, yet postoperative locoregional recurrence and distant metastasis occur frequently and confer high risks of morbidity and mortality Deleterious effects of surgery include the initiation of local and/or systemic inflammation, increased catecholamine levels, immunosuppression, a prothrombotic state, and exposure to anaesthetic agents; these processes overlap with cancer-promoting signalling pathways Cancer cells that escape resection are subject to perioperative physiological changes and might disseminate and colonize distant organs, thus contributing to postoperative cancer recurrence Perioperative use of β-adrenoceptor antagonists, anti-inflammatory drugs, intravenous anaesthetics, and antithrombotic agents is linked with improved survival outcomes in patients with cancer >60% of patients with cancer are treated with surgery; therefore, offsetting the deleterious effects of surgery by use of affordable and readily available therapies might rapidly improve the postoperative survival of patients with cancer