• Anesthesiology · Nov 2018

    Randomized Controlled Trial Comparative Study

    Effect of Equipotent Doses of Propofol versus Sevoflurane Anesthesia on Regulatory T Cells after Breast Cancer Surgery.

    • Chung-Sik Oh, Jaemoon Lee, Tae-Gyoon Yoon, Eun-Hye Seo, Hyun-Jun Park, Liyun Piao, Seung-Hyun Lee, and Seong-Hyop Kim.
    • From the Department of Anesthesiology and Pain Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea (C.-S.O., J.L., S.-H.K.) Department of Anesthesiology and Pain Medicine, Sejong Hospital, Bucheon, Korea (T.-G.Y.) Department of Microbiology (E.-H.S., H.-J.P., L.P., S.-H.L.) Research Institute of Medical Science (S.-H.L., S.-H.K.) the Department of Infection and Immunology, Konkuk University School of Medicine, Seoul, Korea (S.-H.K.).
    • Anesthesiology. 2018 Nov 1; 129 (5): 921-931.

    What We Already Know About This TopicWHAT THIS ARTICLE TELLS US THAT IS NEW: BACKGROUND:: Clusters of differentiation 39 and 73, enzymes expressed on the surface of regulatory T cells, promote cancer recurrence and metastasis by suppressing immune cells. The authors hypothesized that propofol is less immunosuppressive than volatile anesthetics. The objective of this randomized trial was to compare the changes in cluster of differentiation 39 and 73 expression on regulatory T cells between propofol- and sevoflurane-based anesthesia during breast cancer surgery.MethodsA total of 201 patients having breast cancer surgery were randomly assigned and analyzed (n = 99 for propofol, n = 102 for sevoflurane). Blood samples were obtained immediately before anesthesia induction and 1 and 24 h postoperatively. The frequency of cluster of differentiation 39 and 73 expression on circulating regulatory T cells (primary outcome) and the frequency of circulating type 1 and type 17 helper T cells, natural killer cells, and cytotoxic T cells were investigated. Serum cytokines and the neutrophil-to-lymphocyte ratio were also evaluated.ResultsChanges in cluster of differentiation 39 and 73 expression on regulatory T cells over time did not differ with propofol and sevoflurane groups (difference [95% confidence interval]: 0.01 [-2.04 to 2.06], P = 0.995 for cluster of differentiation 39; -0.93 [-3.12 to 1.26], P = 0.403 for cluster of differentiation 73). There were no intergroup differences in type 1, type 17 helper T cells, natural killer cells, cytotoxic T cells, cytokines, or the neutrophil-to-lymphocyte ratio.ConclusionsChanges in immune cells were similar with propofol and sevoflurane during breast cancer surgery. The effect of anesthetics on the perioperative immune activity may be minimal during cancer surgery.

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    This article appears in the collection: Anesthesia technique and cancer recurrence.

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