Impact of propofol on gastrointestinal cancer outcomes: A review of cellular behavior, growth, and metastasis.

Abstract

Cancer is one of the most important health problems that deeply affects all humanity and will have groundbreaking consequences in human history with its elimination. Gastrointestinal cancers, including colon and rectum, stomach, liver, pancreatic, and esophageal, account for 26% of the global cancer incidence and 35% of cancer-related deaths. Unfortunately, it is estimated that today's high incidence and mortality rates will increase by 58% and 73% by 2040, respectively. Although the treatment process includes novel options such as immunotherapy in addition to classical options with a multidisciplinary approach, surgical treatment under general anesthesia remains the leading option. Considering a long-lasting cancer process, it is quite surprising that a very short-term anesthetic administration can have various effects on cancer cell behavior. Various anesthetic approaches such as regional blocks used in pain management, the use of anesthetic adjuvants such as β-adrenoceptor antagonists, nonsteroidal anti-inflammatory drugs, and intravenous lidocaine, and the choice of anesthetic drugs seem to have potential effects on long-term cancer outcomes. Propofol is an intravenous anesthetic drug that is used for both induction and maintenance of general anesthesia. Many in vitro and clinical studies examining the effects of propofol comparatively with other anesthetic agents on tumor recurrence and metastasis revealed possible effects on tumor cell signaling, the immune response, and the modulation of the neuroendocrine stress response. However, the evidence from all these in vitro and clinical studies is different, complicated, and inconsistent. The general effects of propofol on the behavioral patterns, growth, and metastasis of gastrointestinal tumor cells, as well as the clinical features and consequences resulting from these effects, constitute the subject of this review.