Title:“Letting the Air In” Can Set the Stage for Tumor Recurrences
Volume: 8
Issue: 4
Author(s): Benjamin A. Laguna, Zachary C. G. Tucker, Horace DeLisser and Sunil Singhal
Affiliation:
Keywords:
Cell mediated immunity, Immunosuppression, Mechanical seeding, Tumor recurrence
Abstract: Surgery is the single most effective therapy for patients with solid tumors. However, up to half of the patients
who receive surgical resection will relapse from their cancer. Despite the significant benefit from surgery, there is a growing
body of evidence that suggests that surgery may also contribute to tumor recurrence. The evidence supporting this
claim can be divided into immunologic and non-immunologic mechanisms. The non-immunologic mechanisms associated
with surgery include direct seeding through tissue manipulation, pressure activation of malignant cells, the release of angiogenic
factors, and an increase in circulating growth factors. Surgery also has dramatic implications for the immune system;
these include the suppression of cell-mediated immunity, the activation of the neuroendocrine response, and anesthesia
related immunosuppression. The factors associated with post-surgical tumor recurrence are complex; nevertheless, a
better understanding of these mechanisms provides an opportunity to develop therapeutic interventions that can lower the
recurrence rate in patients with solid tumors.
