<div xmlns="http://www.w3.org/1999/xhtml">
<p>Publish: March 1<sup>st</sup>, 2024.</p>
<p>Radiol Oncol 2024; 58(1): 9-14.</p>
<p>doi: 10.2478/raon-2024-0012</p>
<sec id="j_raon-2024-0031_s_001"><div>To the editor</div>
<p>I read with a great interest the review recently published in Radiology and Oncology by Potocnik et al.<sup><a ref-type="bibr" href="#j_raon-2024-0031_ref_001">1</a></sup> Upon examination, I have identified a critical discrepancy between the review’s main text and the cited meta-analysis<sup><a ref-type="bibr" href="#j_raon-2024-0031_ref_002">2</a></sup> results, which seems to have led to a significant misunderstanding in the presentation of the findings.</p>
<p>The review states that in a recent meta-analysis<sup><a ref-type="bibr" href="#j_raon-2024-0031_ref_002">2</a></sup>, patients with breast, esophageal, or non-small cell lung cancer had improved recurrence-free survival after receiving volatile anesthesia (VA) and that overall survival was longer after VA than after total intravenous anesthesia (TIVA). This statement contradicts the findings of the cited meta-analysis, which actually shows that TIVA is associated with improved outcomes both in terms of recurrence-free survival (pooled Hazard Ratio [HR], 0.78; 95% Confidence Interval [CI], 0.65 to 0.94; P &lt; 0.01) and overall survival (pooled HR, 0.76; 95% CI, 0.63 to 0.92; P &lt; 0.01) across several cancer types, including breast, esophageal, colorectal, gastric, and non-small cell lung cancer.</p>
<p>Interestingly, the conclusion section of the review correctly highlights the potential anti-inflammatory, antioxidant, and possibly antitumor effects of propofol (a common TIVA agent) compared to the proinflammatory effects of volatile anesthetics, which could accelerate metastasis. This conclusion aligns with the meta-analysis findings that favor TIVA over VA, suggesting a potential oversight or error in the review’s main text.</p>
<p>Given the significance of these findings for clinical practice and the potential impact on patient care, I believe a clarification and correction of the discrepancy in the review’s main text is crucial. Accurate representation of the meta-analysis results is essential for guiding future research and clinical decisions regarding anesthesia choice in cancer surgery.</p>
<fn-group>
<fn fn-type="other"><p><bold>Notes</bold></p><p>No potential conflict of interest relevant to this letter was report.</p></fn>
</fn-group>
<ref-list><div>References</div>
<ref id="j_raon-2024-0031_ref_001"><label>1.</label>
<mixed-citation>Potocnik I; Kerin-Povsic M, Markovic-Bozic J. The influence of anaesthetic technique on cancer growth. <italic>Radiol Oncol</italic> 2024; <bold>58(1):</bold> 9–14. Available at: <uri>https://www.radioloncol.com/index.php/ro/article/view/4210</uri></mixed-citation>
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<name><surname>Kerin-Povsic</surname><given-names>M</given-names></name>
<name><surname>Markovic-Bozic</surname><given-names>J</given-names></name>
<article-title>The influence of anaesthetic technique on cancer growth</article-title>
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<fpage>9</fpage>
<lpage>14</lpage>
<comment>Available at: <uri>https://www.radioloncol.com/index.php/ro/article/view/4210</uri></comment>
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<ref id="j_raon-2024-0031_ref_002"><label>2.</label>
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<sec id="j_raon-2024-0031_s_002"><div>Responses</div>
<sec id="j_raon-2024-0031_s_002_s_001"><div>The authors reply</div>
<p>While reviewing the article<sup><a ref-type="bibr" href="#j_raon-2024-0031_ref_003">1</a></sup>, we realised that we had made a mistake. Instead of VIMA, we should have written TIVA. Please, accept our apology. In the article, we also cited studies that concluded that volatile anaesthetics have anti-inflammatory action and so might act anti carcinogenic.<sup><a ref-type="bibr" href="#j_raon-2024-0031_ref_004">2</a>,<a ref-type="bibr" href="#j_raon-2024-0031_ref_005">3</a>,<a ref-type="bibr" href="#j_raon-2024-0031_ref_006">4</a>,<a ref-type="bibr" href="#j_raon-2024-0031_ref_007">5</a>,<a ref-type="bibr" href="#j_raon-2024-0031_ref_008">6</a></sup> In the conclusion we also wrote that this area is still quite unexplored and that studies have led to very controversial results. Regarding that please, find enclosed an additional reference of Wang J <italic>et al.</italic><sup><a ref-type="bibr" href="#j_raon-2024-0031_ref_009">7</a></sup>, who proved that volatile anaesthetics have a rule in the anti-cancer relevant signalling. Therefore, above mentioned mistake luckily did not have an effect on the message of the article.</p>
<list list-type="simple">
<list-item><p><bold>Assist. Prof. Iztok Potocnik, M.D., Ph.D.</bold></p></list-item>
<list-item><p>Institute of Oncology Ljubljana, Ljubljana, Slovenia</p></list-item>
<list-item><p>E-mail: <email xmlns:xlink="http://www.w3.org/1999/xlink" xlink:href="mailto:vpotocnik@onko-i.si">vpotocnik@onko-i.si</email></p></list-item></list>
<list list-type="simple">
<list-item><p><bold>Prof. Jasmina Markovic-Bozic, M.D., Ph.D.</bold></p></list-item>
<list-item><p>University Clinical Centre Ljubljana, Ljubljana, Slovenia</p></list-item>
<list-item><p>E-mail: <email xmlns:xlink="http://www.w3.org/1999/xlink" xlink:href="mailto:jasmina.markovicbozic@mf.uni-lj.si">jasmina.markovicbozic@mf.uni-lj.si</email></p></list-item></list>
<fn-group>
<fn fn-type="other"><p><bold>Notes</bold></p><p>No potential conflict of interest relevant to this letter was report.</p></fn>
</fn-group>
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</div>

The influence of anaesthesia on cancer growth

Radiology and Oncology

This work is licensed under the Creative Commons Attribution 4.0 International License.

The influence of anaesthesia on cancer growth

Article Category: Correspondence

Publié en ligne: 11 juin 2024

Pages: 311 - 312

DOI: https://doi.org/10.2478/raon-2024-0031

© 2024 Muhammet Selman Söğüt, published by Sciendo

This work is licensed under the Creative Commons Attribution 4.0 International License.