© 2022 Jordan Kelley
Non-small cell lung cancer (NSCLC) is the most prevalent type of lung cancer. Lung cancer leads all cancer death rates worldwide. Surgical treatment for NSCLC warrants a role for the anesthetist to influence recurrence-free survival, overall survivability, and overall mortality. Literature suggests propofol and sevoflurane are linked to immunosuppressive characteristics by decreasing immunity via different mechanisms. Propofol has known anti-inflammatory effects, but studies reveal sevoflurane has similar capabilities. Sevoflurane may attenuate the metastatic potential of lung cancer by stopping platelet activation, but sevoflurane may also enhance other pathways of metastasis. Similarly, propofol has anti-metastatic abilities, hindering angiogenesis by downregulating necessary growth factors. Propofol and sevoflurane influence various NSCLC growth and metastasis mechanisms, but research is inconclusive on how propofol or sevoflurane definitively affects outcomes with NSCLC. Heterogenous clinical evidence supports a propofol TIVA for improved recurrence-free survivability, increased overall survivability, and decreased overall mortality more than inhalation anesthetics. Ultimately, more research is needed to justify the preferred anesthetic.
Kelley, Jordan, "The Effects Of Propofol Versus Sevoflurane In Surgical Lung Cancer Patients" (2022). Nurse Anesthesia Student Capstones. 43.