Mécanismes de l'oncogenèse et principe des traitements anticancéreux : implication pour l'anesthésiste

Cancer is the leading cause of death in France. Oncogenesis results from an imbalance between proto-oncogenes and antioncogenes. Natural killer cells activity is depressed perioperatively. Other mechanisms may favour the occurrence of cancer cells metastasis after surgery, such as the suppression of angiogenesis inhibition by tumour withdrawal, and the release of tumour growth factors and tumour cells into the blood stream. Chemotherapy and targeted biotherapy impair perioperative management due to their hematologic, cardiovascular, respiratory, neurological, and haemostatic side effects or to an impairment of tissue healing. Intraperitoneal chemotherapy induces significant metabolic disturbances. Anaesthetic technique may also impair tumour cells multiplication through complex mechanisms.