Effect of anesthetic technique on antitumor immunity in patients undergoing surgery for gall bladder cancer: A prospective randomized comparative study.

There is a paucity of literature regarding the effect of anesthetic techniques on antitumor immunity, especially in gall bladder malignancies. We designed a study to compare the effect of propofol‐based total intravenous anesthesia and sevoflurane‐based general anesthesia—on antitumor immunity, including tumor growth factor‐β (TGF‐β), T‐helper cell profile, and inflammatory markers. A pilot prospective randomized trial was conducted in 64 patients undergoing surgery for gall bladder malignancy under general anesthesia in a tertiary specialty cancer hospital. Adult cancer patients of ASA physical status I‐III fulfilling the inclusion criteria were randomized to either group S (sevoflurane‐based general anesthesia) or group T (propofol‐based total intravenous anesthesia). Preoperative (morning of surgery) and postoperative (24 h and 1 month after surgery) blood samples were obtained. Demographic profile and preoperative parameters were comparable between both groups. There was a statistically significant difference in the postoperative value of TGF‐β (higher in group T). There was a statistically significant difference in postoperative interleukin‐17A value (indicative of TH17 cells), and it was found to be higher in group S. Propofol‐based TIVA increases serum TGF‐β levels. At the same time, Sevoflurane modulates T‐helper cells‐based immunity to increase TH17 cells in patients with gall bladder cancer. Multiple larger studies will be required to validate the results and provide useful recommendations. [ABSTRACT FROM AUTHOR]