TY - JOUR T1 - Impact of perioperative pain management on cancer recurrence: an ASRA/ESRA special article JF - Regional Anesthesia & Pain Medicine JO - Reg Anesth Pain Med SP - 13 LP - 28 DO - 10.1136/rapm-2018-000001 VL - 44 IS - 1 AU - Andres Missair AU - Juan Pablo Cata AU - Gina Votta-Velis AU - Mark Johnson AU - Alain Borgeat AU - Mohammed Tiouririne AU - Vijay Gottumukkala AU - Donal Buggy AU - Ricardo Vallejo AU - Esther Benedetti de Marrero AU - Dan Sessler AU - Marc A Huntoon AU - Jose De Andres AU - Oscar De Leon Casasola Y1 - 2019/01/01 UR - http://rapm.bmj.com/content/44/1/13.abstract N2 - Cancer causes considerable suffering and 80% of advanced cancer patients experience moderate to severe pain. Surgical tumor excision remains a cornerstone of primary cancer treatment, but is also recognized as one of the greatest risk factors for metastatic spread. The perioperative period, characterized by the surgical stress response, pharmacologic-induced angiogenesis, and immunomodulation results in a physiologic environment that supports tumor spread and distant reimplantation.In the perioperative period, anesthesiologists may have a brief and uniquewindow of opportunity to modulate the unwanted consequences of the stressresponse on the immune system and minimize residual disease. This reviewdiscusses the current research on analgesic therapies and their impact ondisease progression, followed by an evidence-based evaluation of perioperativepain interventions and medications. ER -