Impacto da técnica anestésica no comportamento evolutivo do câncer de mama: uma revisão sistemática de literatura
DOI:
https://doi.org/10.11606/issn.1679-9836.v100i1p35-40Palavras-chave:
Revisão sistemática, Câncer de mama, Mastectomia, Anestesia localResumo
Apesar de ser uma importante abordagem para o tratamento do câncer de mama, a cirurgia pode paradoxalmente favorecer a progressão tumoral, apesar da intenção curativa. Como as técnicas de anestesia local podem ser uma oportunidade terapêutica para reduzir a manutenção e dispersão neoplásica, o objetivo do estudo foi avaliar seus efeitos no comportamento evolutivo do câncer de mama no contexto clínico. Trata-se de uma revisão sistemática de literatura a partir da base de dados PubMed com os descritores MeSH “mastectomy”, “mastectomy, radical”, “anesthesia, local”, “recurrence”, “neoplasm recurrence, local”. Foram selecionados seis artigos, sendo a maioria retrospectivo e apenas um estudo controlado randomizado. Entre as diferenças discutidas na análise de variáveis, critérios de inclusão e resultados observados, cinco estudos não apresentaram efeito sobre o comportamento evolutivo do câncer de mama. Assim, apesar dos potenciais benefícios da anestesia local sobre o comportamento evolutivo do câncer de mama, essa revisão não encontrou evidência suficiente para apoiar essa intervenção para a prática clínica. Apesar disso, pode reduzir o consumo de opioide e prover uma opção viável para o manejo da dor, que pode melhorar a qualidade de vida das pacientes.
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Referências
Instituto Nacional de Câncer José Alencar Gomes da Silva (INCA). Estimativa 2020: incidência de câncer no Brasil. Rio de Janeiro: INCA; 2019. Disponível em: https://www.inca.gov.br/sites/ufu.sti.inca.local/files//media/document//estimativa-2020-incidencia-de-cancer-no-brasil.pdf.
Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018;68(6):394-424. doi: https://doi.org/10.3322/caac.21492.
Kesson EM, Allardice GM, George WD, Burns HJ, Morrison DS. Effects of multidisciplinary team working on breast cancer survival: retrospective, comparative, interventional cohort study of 13 722 women. BMJ. 2012;344:e2718. doi:https://doi.org/10.1136/bmj.e2718.
Freitas-Júnior R, Gagliato DM, Moura Filho JWC, Gouveia PA, Rahal RMS, Paulinelli RR, Oliveira LFP, Freitas PF, Martins E, Urban C, Lucena CEM. Trends in breast cancer surgery at Brazil’s public health system. J Surg Oncol. 2017;115(5):544-9. doi: https://doi.org/10.1002/jso.24572.
Hiller JG, Perry NJ, Poulogiannis G, Riedel B, Sloan EK. Perioperative events influence cancer recurrence risk after surgery. Nat Rev Clin Oncol. 2018;15(4):205-18. doi: https://doi.org/10.1038/nrclinonc.2017.194.
Horowitz M, Neeman E, Sharon E, Ben-Eliyahu S. Exploiting the critical perioperative period to improve long-term cancer outcomes. Nat Rev Clin Oncol. 2015;12(4):213-26. doi: https://doi.org/10.1038/nrclinonc.2014.224.
Gottschalk A, Sharma S, Ford J, Durieux ME, Tiouririne M. Review article: the role of the perioperative period in recurrence after cancer surgery. Anesth Analg. 2010;110(6):1636-43. doi: https://doi.org/10.1213/ANE.0b013e3181de0ab6.
Ben-Eliyahu S, Page GG, Yirmiya R, Shakhar G. Evidence that stress and surgical interventions promote tumor development by suppressing natural killer cell activity. Int J Cancer. 1999;80(6):880-8. doi: https://doi.org/10.1002/(sici)1097-0215(19990315)80:6<880::aid-ijc14>3.0.co;2-y.
Heaney A, Buggy DJ. Can anaesthetic and analgesic techniques affect cancer recurrence or metastasis? Br J Anaesth. 2012 Dec;109 Suppl 1:i17-i28. doi: https://doi.org/10.1093/bja/aes421.
Kurosawa S, Kato M. Anesthetics, immune cells, and immune responses. J Anesth. 2008;22(3):263-77. doi: https://doi.org/10.1007/s00540-008-0626-2.
Exadaktylos AK, Buggy DJ, Moriarty DC, Mascha E, Sessler DI. Can anesthetic technique for primary breast cancer surgery affect recurrence or metastasis? Anesthesiology. 2006;105(4):660-4. doi: https://doi.org/10.1097/00000542-200610000-00008.
Sessler DI, Pei L, Huang Y, et al. Recurrence of breast cancer after regional or general anaesthesia: a randomised controlled trial. Lancet. 2019;394(10211):1807-15. doi: https://doi.org/10.1016/S0140-6736(19)32313-X.
Starnes-Ott K, Goravanchi F, Meininger JC. Anesthetic choices and breast cancer recurrence: a retrospective pilot study of patient, disease, and treatment factors. Crit Care Nurs Q. 2015;38(2):200-10. doi: https://doi.org/10.1097/CNQ.0000000000000062.
Tsigonis AM, Al-Hamadani M, Linebarger JH, Vang CA, Krause FJ, Johnson JM, Marchese E, Marcou KA, Hudak JM, Landercasper J. Are cure rates for breast cancer improved by local and regional anesthesia? Reg Anesth Pain Med. 2016;41(3):339-47. doi: https://doi.org/10.1097/AAP.0000000000000379.
Cata JP, Chavez-MacGregor M, Valero V, Black W, Black DM, Goravanchi F, Ifeanyi IC, Hernandez M, Rodriguez-Restrepo A, Gottumukkala V. The impact of paravertebral block analgesia on breast cancer survival after surgery. Reg Anesth Pain Med. 2016;41(6):696-703. doi: https://doi.org/10.1097/AAP.0000000000000479.
Karmakar MK, Samy W, Lee A, Li JW, Chan WC, Chen PP, Tsui BCH. Survival analysis of patients with breast cancer undergoing a modified radical mastectomy with or without a thoracic paravertebral block: a 5-year follow-up of a Randomized Controlled Trial. Anticancer Res. 2017;37(10):5813-20. doi: https://doi.org/10.21873/anticanres.12024.
Gray E, Donten A, Payne K, Hall PS. Survival estimates stratified by the Nottingham Prognostic Index for early breast cancer: a systematic review and meta-analysis of observational studies. Syst Rev. 2018;7(1):142. doi: https://doi.org/10.1186/s13643-018-0803-9.
Ecker BL, Lee JY, Sterner CJ, Solomon AC, Pant DK, Shen F, Peraza J, Vaught L, Mahendra S, Belka GK, Pan TC, Schmitz KH, Chodosh LA. Impact of obesity on breast cancer recurrence and minimal residual disease. Breast Cancer Res. 2019;21(1):41. doi: https://doi.org/10.1186/s13058-018-1087-7.
Karmakar MK, Samy W, Li JW, Lee A, Chan WC, Chen PP, Ho AM. Thoracic paravertebral block and its effects on chronic pain and health-related quality of life after modified radical mastectomy. Reg Anesth Pain Med. 2014;39(4):289-98. doi: https://doi.org/10.1097/AAP.0000000000000113.
Hiller JG, Parat M-O, Ben-Eliyahu S. The Role of Perioperative Pharmacological Adjuncts in Cancer Outcomes: Beta-Adrenergic Receptor Antagonists, NSAIDs and Anti-fibrinolytics. Curr Anesthesiol Rep. 2015;5(3):291-304. doi: https://doi.org/10.1007/s40140-015-0113-x.
Retsky M, Demicheli R, Hrushesky WJ, Forget P, De Kock M, Gukas I, Rogers RA, Baum M, Sukhatme V, Vaidya JS. Reduction of breast cancer relapses with perioperative non-steroidal anti-inflammatory drugs: new findings and a review. Curr Med Chem. 2013;20(33):4163-76. doi: https://doi.org/10.2174/09298673113209990250.
Beecher SM, O’Leary DP, McLaughlin R, Sweeney KJ, Kerin MJ. Influence of complications following immediate breast reconstruction on breast cancer recurrence rates. Br J Surg. 2016;103(4):391-8. doi: https://doi.org/10.1002/bjs.10068.
Ecimovic P, Murray D, Doran P, Buggy DJ. Propofol and bupivacaine in breast cancer cell function in vitro - role of the NET1 gene. Anticancer Res. 2014;34(3):1321-31. Available from: https://ar.iiarjournals.org/content/34/3/1321.long.
Melamed R, Bar-Yosef S, Shakhar G, Shakhar K, Ben-Eliyahu S. Suppression of natural killer cell activity and promotion of tumor metastasis by ketamine, thiopental, and halothane, but not by propofol: mediating mechanisms and prophylactic measures. Anesth Analg. 2003;97(5):1331-9. doi: https://doi.org/10.1213/01.ane.0000082995.44040.07.
Desmond F, McCormack J, Mulligan N, Stokes M, Buggy DJ. Effect of anaesthetic technique on immune cell infiltration in breast cancer: a follow-up pilot analysis of a prospective, Randomised, Investigator-Masked Study. Anticancer Res. 2015;35(3):1311-9. Available from: https://ar.iiarjournals.org/content/35/3/1311.long.
Pei L, Zhou Y, Tan G, Mao F, Yang D, Guan J, Lin Y, Wang X, Zhang Y, Zhang X, Shen S, Xu Z, Sun Q, Huang Y; Outcomes Research Consortium. Ultrasound-Assisted Thoracic Paravertebral Block Reduces Intraoperative Opioid Requirement and Improves Analgesia after Breast Cancer Surgery: a Randomized, Controlled, Single-Center Trial. PLoS One. 2015;10(11):e0142249. doi: https://doi.org/10.1371/journal.pone.0142249.
Faria SS, Gomez RS. Aplicação clínica do bloqueio anestésico paravertebral torácico em operações de mama. Rev Bras Anestesiol. 2015;65(2):147-54. doi: https://doi.org/10.1016/j.bjan.2013.07.018.
Feeney LR, Tormey SM, Harmon DC. Breast cancer and chronic pain: a mixed methods review. Ir J Med Sci. 2018;187(4):877-85. doi: https://doi.org/10.1007/s11845-018-1760-y.
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Copyright (c) 2021 Marcela Chagas Lima Mussi, Arthur Giovane Campos Batista, Clécio Ênio Murta de Lucena
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