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Review
. 2022 Jul 11:9:888630.
doi: 10.3389/fsurg.2022.888630. eCollection 2022.

Perioperative Inflammatory Response and Cancer Recurrence in Lung Cancer Surgery: A Narrative Review

Hoon Choi  1 , Wonjung Hwang  1
Affiliations
Review

Perioperative Inflammatory Response and Cancer Recurrence in Lung Cancer Surgery: A Narrative Review

Hoon Choi et al. Front Surg. .

Abstract

While surgical resection is the gold standard treatment for solid tumors, cancer recurrence after surgery is common. Immunosurveillance of remnant tumor cells is an important protective mechanism. Therefore, maintenance of anti-tumor cell activity and proper levels of inflammatory mediators is crucial. An increasing body of evidence suggests that surgery itself and perioperative interventions could affect these pathophysiological responses. Various factors, such as the extent of tissue injury, perioperative medications such as anesthetics and analgesics, and perioperative management including transfusions and methods of mechanical ventilation, modulate the inflammatory response in lung cancer surgery. This narrative review summarizes the pathophysiological mechanisms involved in cancer recurrence after surgery and perioperative management related to cancer recurrence after lung cancer surgery.

Keywords: inflammation; lung cancer; neoplasm metastasis; neoplasm recurrence; perioperative management.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Overview of surgical stress response. Surgical trauma induce sympathetic activation, followed by imbalanced inflammation and immunosuppression. These changes promote remnant tumor cells survival and distant metastasis. PGE2, prostaglandin E2; NET, neutrophil extracellular traps; Treg, regulatory T cell, Th, helper T cell; Tc, cytotoxic T cell; NK cell, natural killer cell; MDSC, myeloid-derived suppressor cell.
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