Surgery for Cancer: A Trigger for Metastases
Top Cited Papers
- 1 April 2017
- journal article
- review article
- Published by American Association for Cancer Research (AACR) in Cancer Research
- Vol. 77 (7), 1548-1552
- https://doi.org/10.1158/0008-5472.can-16-1536
Abstract
Surgery is a crucial intervention and provides a chance of cure for patients with cancer. The perioperative period is characterized by an increased risk for accelerated growth of micrometastatic disease and increased formation of new metastatic foci. The true impact for cancer patients remains unclear. This review summarizes the often fragmentary clinical and experimental evidence supporting the role of surgery and inflammation as potential triggers for disease recurrence. Surgery induces increased shedding of cancer cells into the circulation, suppresses antitumor immunity allowing circulating cells to survive, upregulates adhesion molecules in target organs, recruits immune cells capable of entrapping tumor cells, and induces changes in the target tissue and in the cancer cells themselves to enhance migration and invasion to establish at the target site. Surgical trauma induces local and systemic inflammatory responses that can also contribute to the accelerated growth of residual and micrometastatic disease. Furthermore, we address the role of perioperative factors, including anesthesia, transfusions, hypothermia, and postoperative complications, as probable deleterious factors contributing to early recurrence. Through the admittedly limited understanding of these processes, we will attempt to provide suggestions for potential new therapeutic approaches to target the protumorigenic perioperative window and ultimately improve long-term oncological outcomes. Cancer Res; 77(7); 1548–52. ©2017 AACR.Funding Information
- NIH (T32CA113263)
This publication has 34 references indexed in Scilit:
- Neutrophil extracellular traps sequester circulating tumor cells and promote metastasisJCI Insight, 2013
- Cancer-related inflammation, the seventh hallmark of cancer: links to genetic instabilityCarcinogenesis: Integrative Cancer Research, 2009
- Anti-β1 Integrin Antibody Reduces Surgery-Induced Adhesion of Colon Carcinoma Cells to Traumatized Peritoneal SurfacesAnnals of Surgery, 2008
- Blocking α2 integrins on rat CC531s colon carcinoma cells prevents operation-induced augmentation of liver metastases outgrowthHepatology, 2007
- Cancer surgery: risks and opportunitiesBioEssays, 2006
- Macrophages direct tumour histology and clinical outcome in a colon cancer modelThe Journal of Pathology, 2005
- Detection of Hematogenous Tumor Cell Dissemination Predicts Tumor Relapse in Patients Undergoing Surgical Resection of Colorectal Liver MetastasesAnnals of Surgery, 2005
- Dissemination and growth of cancer cells in metastatic sitesNature Reviews Cancer, 2002
- Improved survival after one course of perioperative chemotherapy in early breast cancer patients: long-term results from the European Organization for Research and Treatment of Cancer (EORTC) Trial 10854European Journal of Cancer, 2001
- Dormancy, Regression, and Recurrence: Towards a Unifying Theory of Tumor Growth ControlJournal of Theoretical Biology, 1994