Surgical stress and cancer progression: the twisted tango.
Document Type Article
This article has been peer reviewed. It is the author’s final published version in Molecular Cancer, Volume 18, Issue 1, September 2019, Article number 132.
The published version is available at https://doi.org/10.1186/s12943-019-1058-3. Copyright © Chen et al.
Surgical resection is an important avenue for cancer treatment, which, in most cases, can effectively alleviate the patient symptoms. However, accumulating evidence has documented that surgical resection potentially enhances metastatic seeding of tumor cells. In this review, we revisit the literature on surgical stress, and outline the mechanisms by which surgical stress, including ischemia/reperfusion injury, activation of sympathetic nervous system, inflammation, systemically hypercoagulable state, immune suppression and effects of anesthetic agents, promotes tumor metastasis. We also propose preventive strategies or resolution of tumor metastasis caused by surgical stress.