Serum NETosis expression and recurrence risk after regional or volatile anaesthesia during breast cancer surgery: A pilot, prospective, randomised single-blind clinical trial

dc.check.date2021-11-13
dc.check.infoAccess to this article is restricted until 12 months after publication by request of the publisher.en
dc.contributor.authorAghamelu, Onyinye
dc.contributor.authorBuggy, Padraig
dc.contributor.authorSmith, Genevieve
dc.contributor.authorInzitari, Rosanna
dc.contributor.authorWall, Tom P.
dc.contributor.authorBuggy, Donal P.
dc.date.accessioned2020-12-18T09:56:59Z
dc.date.available2020-12-18T09:56:59Z
dc.date.issued2020-11-13
dc.description.abstractBackground: Some experimental and retrospective clinical studies signal an association between certain anaesthetic techniques and tumour metastasis following breast cancer surgery. Neutrophil Extracellular Trapping (NETosis) is an immunological process, whereby neutrophils engulf tumour antigen then degranulate, leaving a serologic marker. NETosis expression among breast cancer patients is associated with an increased risk of metastasis. We investigated the effect of two distinct anaesthetic techniques on the expression of NETosis in women who underwent potentially curative breast cancer surgery. Methods: In a parallel-group, randomised controlled trial, a subset of women (n = 40) undergoing breast cancer resection surgery, who were partaking in a larger trial (NCT00418457), were randomly assigned to receive volatile general anaesthesia (GA) or propofol GA combined with paravertebral regional anaesthesia (PPA) for their surgery. Serum was taken and stored before and 24 hours post-operatively. NETosis was measured by ELISA using Neutrophil Myeloperoxidase (MPO) and citrullinated histone H3 (H3Cit) biomarkers, which were the co-primary end points. Results: Patient and breast cancer characteristics did not differ significantly between groups. Recurrence occurred in 7.5% patients. GA patients received more opioids and reported higher post-operative pain than PPA. There was no difference in post-operative MPO in GA vs PPA (10.5 ± 6.6 vs 11.5 ± 4.7 ng mL−1, P =.60). Regarding CitH3, there was no difference post-operatively in GA vs PPA (3.6 ± 2.3 vs 4.0 ± 5.9, P =.80). NET expression did not differ before or after anaesthesia and surgery in either group, for either biomarker. Conclusion: Anaesthetic technique did not affect NETosis expression in breast cancer patients, indicating that it is not a viable marker of the effect of anaesthetic technique on breast cancer recurrence.en
dc.description.statusPeer revieweden
dc.description.versionPublished Versionen
dc.format.mimetypeapplication/pdfen
dc.identifier.citationAghamelu, O., Buggy, P., Smith, G., Inzitari, R., Wall, T. and Buggy, D. J.(2020) 'Serum NETosis expression and recurrence risk after regional or volatile anaesthesia during breast cancer surgery: A pilot, prospective, randomised single-blind clinical trial', Acta Anaesthesiologica Scandinavica, (7 pp). doi: 10.1111/aas.13745en
dc.identifier.doi10.1111/aas.13745en
dc.identifier.eissn1399-6576
dc.identifier.endpage7en
dc.identifier.issn0001-5172
dc.identifier.journaltitleActa Anaesthesiologica Scandinavicaen
dc.identifier.startpage1en
dc.identifier.urihttps://hdl.handle.net/10468/10842
dc.language.isoenen
dc.publisherWileyen
dc.relation.urihttps://onlinelibrary.wiley.com/doi/full/10.1111/aas.13745
dc.rights© 2020 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd. This is the peer reviewed version of the article published in Acta Anaesthesiologica Scandinavica, which has been published in final form at https://doi.org/10.1111/aas.13745 .This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.en
dc.subjectAnaesthesiologyen
dc.subjectBreast canceren
dc.subjectCanceren
dc.subjectMetastasisen
dc.subjectNeutrophilen
dc.subjectExtracellular trappingen
dc.titleSerum NETosis expression and recurrence risk after regional or volatile anaesthesia during breast cancer surgery: A pilot, prospective, randomised single-blind clinical trialen
dc.typeArticle (peer-reviewed)en
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