{"title":"Volatiles vs. TIVA – Is there a difference in cancer patients","authors":"Bente FH. Dubois, Markus W. Hollmann","doi":"10.1016/j.bpa.2025.03.002","DOIUrl":null,"url":null,"abstract":"<div><div>Cancer incidence continues to rise, with 20 million new cases and 9.7 million cancer-related deaths reported in 2022. With the vast majority of these patients requiring anaesthesia. However, despite surgical resection, nearly one-third of patients experience local recurrence or distant metastases. Perioperative factors, including surgical stress and anaesthetic technique, may influence recurrence, though tumour biology remains not fully understood.</div><div>The impact of total intravenous anaesthesia (TIVA) versus inhalation anaesthesia (IA) on oncological outcomes has attracted growing interest. While some studies suggest a potential advantage of propofol-based TIVA, the probability of a clinically significant effect remains low. The existing literature consists mainly of retrospective studies and small randomised trials (RCT's) with methodological limitations.</div><div>Currently, there is no strong evidence that TIVA or IA has a meaningful impact on cancer-free survival. This review critically examines the available research and presents an alternative perspective on this controversial topic.</div></div>","PeriodicalId":48541,"journal":{"name":"Best Practice & Research-Clinical Anaesthesiology","volume":"39 1","pages":"Pages 23-29"},"PeriodicalIF":2.8000,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Best Practice & Research-Clinical Anaesthesiology","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1521689625000084","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ANESTHESIOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Cancer incidence continues to rise, with 20 million new cases and 9.7 million cancer-related deaths reported in 2022. With the vast majority of these patients requiring anaesthesia. However, despite surgical resection, nearly one-third of patients experience local recurrence or distant metastases. Perioperative factors, including surgical stress and anaesthetic technique, may influence recurrence, though tumour biology remains not fully understood.
The impact of total intravenous anaesthesia (TIVA) versus inhalation anaesthesia (IA) on oncological outcomes has attracted growing interest. While some studies suggest a potential advantage of propofol-based TIVA, the probability of a clinically significant effect remains low. The existing literature consists mainly of retrospective studies and small randomised trials (RCT's) with methodological limitations.
Currently, there is no strong evidence that TIVA or IA has a meaningful impact on cancer-free survival. This review critically examines the available research and presents an alternative perspective on this controversial topic.