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Published in: Surgery Today 5/2014

01-05-2014 | Review Article

Regulating surgical oncotaxis to improve the outcomes in cancer patients

Authors: Toshihiro Hirai, Hideo Matsumoto, Hisako Kubota, Yoshiyuki Yamaguchi

Published in: Surgery Today | Issue 5/2014

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Abstract

Excessive surgical stress and postoperative complications cause a storm of perioperative cytokine release, which has been shown to enhance tumor metastasis in experimental models. We have named this phenomenon “surgical oncotaxis”. The mechanisms that underpin this process are thought to be excessive corticosteroid secretion, coagulopathy in the peripheral vasculature, immune suppression and excessive production of reactive oxygen species. Nuclear factor-kappa B (NFkB) activation plays a key role in these mechanisms. Minimally invasive surgical techniques should be used, and postoperative complications should be avoided whenever possible to lessen the impact of surgical oncotaxis. Furthermore, there may be a role for a small preoperative dose of corticosteroid or the use of free radical scavengers in the perioperative period. Recently, there has been a great deal of interest in omega-3 fatty acid, because it regulates NFkB activation. The use of multimodal treatments that regulate surgical oncotaxis may be as important as chemotherapy for determining the outcome of patients with cancer undergoing surgery.
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Metadata
Title
Regulating surgical oncotaxis to improve the outcomes in cancer patients
Authors
Toshihiro Hirai
Hideo Matsumoto
Hisako Kubota
Yoshiyuki Yamaguchi
Publication date
01-05-2014
Publisher
Springer Japan
Published in
Surgery Today / Issue 5/2014
Print ISSN: 0941-1291
Electronic ISSN: 1436-2813
DOI
https://doi.org/10.1007/s00595-013-0627-0

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