Sleeping Beauty: Anesthesia May Promote Relapse in Dogs With Diffuse Large B-Cell Lymphoma in Complete Remission After Chemo-Immunotherapy

Surgery-induced stress and anesthesia-related immunosuppression are believed to play a critical role in human oncology patients. Studies have hypothesized that anesthesia influences patients' outcome, promoting tumor recurrence and metastasis. Aim of the study was to investigate whether anesthe...

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Autores principales:	Eugenio Faroni, Silvia Sabattini, Jacopo Lenzi, Dina Guerra, Stefano Comazzi, Luca Aresu, Alessia Mazzanti, Stefano Zanardi, Veronica Cola, Emilio Lotito, Laura Marconato
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	anesthesia dog immunosuppression lymphoma propofol TIVA Veterinary medicine SF600-1100
Acceso en línea:	https://doaj.org/article/f720dc286db749d0b6ef1d26cf40d179
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spelling	oai:doaj.org-article:f720dc286db749d0b6ef1d26cf40d1792021-11-22T05:04:38ZSleeping Beauty: Anesthesia May Promote Relapse in Dogs With Diffuse Large B-Cell Lymphoma in Complete Remission After Chemo-Immunotherapy2297-176910.3389/fvets.2021.760603https://doaj.org/article/f720dc286db749d0b6ef1d26cf40d1792021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fvets.2021.760603/fullhttps://doaj.org/toc/2297-1769Surgery-induced stress and anesthesia-related immunosuppression are believed to play a critical role in human oncology patients. Studies have hypothesized that anesthesia influences patients' outcome, promoting tumor recurrence and metastasis. Aim of the study was to investigate whether anesthesia promoted relapse in dogs with diffuse large B-cell lymphoma (DLBCL). Medical records were searched for dogs with DLBCL, that were in complete remission (CR) after the same chemo-immunotherapy protocol. Dogs receiving anesthesia were included if the procedure was performed while in CR. Time to relapse (TTR) was obtained via Kaplan–Meier method. Association between anesthesia and relapse was assessed using a nested case-control design and estimated using conditional logistic regression. Sixty-one dogs with DLBCL were included. Overall median TTR was 329 days (95% CI, 281–377). Forty-eight (79%) dogs relapsed during the study period, while 13 (21%) were still in CR at data analysis closure. Eighteen (30%) dogs received anesthesia with opioids, propofol, and isoflurane or sevoflurane. The relative risk of lymphoma relapse for dogs undergoing anesthesia was significantly higher compared with dogs not undergoing anesthesia, with an odds ratio of 3.09 (P = 0.019) on multivariable analysis. Anesthesia may promote relapse in dogs with DLBCL treated with chemo-immunotherapy, although a role of perioperative stress cannot be ultimately excluded. Considering the high frequency of anesthetic procedures required for diagnostic and therapeutic protocols among oncology patients, it is of utmost interest to characterize the effects of single anesthetic agents on the immune system. Further prospective studies are needed to better define the impact of anesthesia on patients' outcome.Eugenio FaroniSilvia SabattiniJacopo LenziDina GuerraStefano ComazziLuca AresuAlessia MazzantiStefano ZanardiVeronica ColaEmilio LotitoLaura MarconatoFrontiers Media S.A.articleanesthesiadogimmunosuppressionlymphomapropofolTIVAVeterinary medicineSF600-1100ENFrontiers in Veterinary Science, Vol 8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	anesthesia dog immunosuppression lymphoma propofol TIVA Veterinary medicine SF600-1100
spellingShingle	anesthesia dog immunosuppression lymphoma propofol TIVA Veterinary medicine SF600-1100 Eugenio Faroni Silvia Sabattini Jacopo Lenzi Dina Guerra Stefano Comazzi Luca Aresu Alessia Mazzanti Stefano Zanardi Veronica Cola Emilio Lotito Laura Marconato Sleeping Beauty: Anesthesia May Promote Relapse in Dogs With Diffuse Large B-Cell Lymphoma in Complete Remission After Chemo-Immunotherapy
description	Surgery-induced stress and anesthesia-related immunosuppression are believed to play a critical role in human oncology patients. Studies have hypothesized that anesthesia influences patients' outcome, promoting tumor recurrence and metastasis. Aim of the study was to investigate whether anesthesia promoted relapse in dogs with diffuse large B-cell lymphoma (DLBCL). Medical records were searched for dogs with DLBCL, that were in complete remission (CR) after the same chemo-immunotherapy protocol. Dogs receiving anesthesia were included if the procedure was performed while in CR. Time to relapse (TTR) was obtained via Kaplan–Meier method. Association between anesthesia and relapse was assessed using a nested case-control design and estimated using conditional logistic regression. Sixty-one dogs with DLBCL were included. Overall median TTR was 329 days (95% CI, 281–377). Forty-eight (79%) dogs relapsed during the study period, while 13 (21%) were still in CR at data analysis closure. Eighteen (30%) dogs received anesthesia with opioids, propofol, and isoflurane or sevoflurane. The relative risk of lymphoma relapse for dogs undergoing anesthesia was significantly higher compared with dogs not undergoing anesthesia, with an odds ratio of 3.09 (P = 0.019) on multivariable analysis. Anesthesia may promote relapse in dogs with DLBCL treated with chemo-immunotherapy, although a role of perioperative stress cannot be ultimately excluded. Considering the high frequency of anesthetic procedures required for diagnostic and therapeutic protocols among oncology patients, it is of utmost interest to characterize the effects of single anesthetic agents on the immune system. Further prospective studies are needed to better define the impact of anesthesia on patients' outcome.
format	article
author	Eugenio Faroni Silvia Sabattini Jacopo Lenzi Dina Guerra Stefano Comazzi Luca Aresu Alessia Mazzanti Stefano Zanardi Veronica Cola Emilio Lotito Laura Marconato
author_facet	Eugenio Faroni Silvia Sabattini Jacopo Lenzi Dina Guerra Stefano Comazzi Luca Aresu Alessia Mazzanti Stefano Zanardi Veronica Cola Emilio Lotito Laura Marconato
author_sort	Eugenio Faroni
title	Sleeping Beauty: Anesthesia May Promote Relapse in Dogs With Diffuse Large B-Cell Lymphoma in Complete Remission After Chemo-Immunotherapy
title_short	Sleeping Beauty: Anesthesia May Promote Relapse in Dogs With Diffuse Large B-Cell Lymphoma in Complete Remission After Chemo-Immunotherapy
title_full	Sleeping Beauty: Anesthesia May Promote Relapse in Dogs With Diffuse Large B-Cell Lymphoma in Complete Remission After Chemo-Immunotherapy
title_fullStr	Sleeping Beauty: Anesthesia May Promote Relapse in Dogs With Diffuse Large B-Cell Lymphoma in Complete Remission After Chemo-Immunotherapy
title_full_unstemmed	Sleeping Beauty: Anesthesia May Promote Relapse in Dogs With Diffuse Large B-Cell Lymphoma in Complete Remission After Chemo-Immunotherapy
title_sort	sleeping beauty: anesthesia may promote relapse in dogs with diffuse large b-cell lymphoma in complete remission after chemo-immunotherapy
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/f720dc286db749d0b6ef1d26cf40d179
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Sleeping Beauty: Anesthesia May Promote Relapse in Dogs With Diffuse Large B-Cell Lymphoma in Complete Remission After Chemo-Immunotherapy

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