Perry James A, Douglas Hope
Veterinary Cancer and Surgery Specialists, 10400 Southeast Main Street, Milwaukie, OR 97222, USA.
University of Pennsylvania, Department of Clinical Sciences and Advanced Medicine, School of Veterinary Medicine, 3900 Delancey Street, Philadelphia, PA 19104, USA.
Vet Clin North Am Small Anim Pract. 2019 Nov;49(6):981-991. doi: 10.1016/j.cvsm.2019.07.008.
Surgery is the mainstay of therapy for canine and human solid cancers. Alarmingly, evidence suggests that the process of surgery may exacerbate metastasis and accelerate the kinetics of cancer progression. Understanding the mechanisms by which cancer progression is accelerated as a result of surgery may provide pharmacologic interventions. This review discusses surgery-induced cancer progression. It focuses on immunomodulatory properties of anesthesia and opioids and evidence that studies evaluating the role of opioids in tumor progression are indicated. It concludes by discussing why companion animals with spontaneously arising cancer are an ideal model for clinical trials to investigate this phenomenon.
手术是犬类和人类实体癌治疗的主要手段。令人担忧的是，有证据表明手术过程可能会加剧转移并加速癌症进展的动力学。了解手术导致癌症进展加速的机制可能会提供药物干预措施。这篇综述讨论了手术诱发的癌症进展。它重点关注麻醉和阿片类药物的免疫调节特性，以及表明评估阿片类药物在肿瘤进展中作用的研究的证据。最后讨论了为什么患有自发性癌症的伴侣动物是研究这一现象的临床试验的理想模型。
