Abstract
Objectives:
Head and neck squamous cell carcinoma (HNSCC) has an unfortunately high rate of recurrence. Recent evidence suggests that the type of anesthesia used during surgery may affect a tumor’s molecular biology, thereby influencing its response to treatment. In this pilot study, we test the hypothesis that different forms of anesthesia will affect the differential expression of several pro-survival cellular proteins in HNSCC utilizing morphoproteomic analysis.
Methods:
Between September 2013 and January 2014, 10 patients underwent surgical resection of previously untreated oral cavity and/or oropharyngeal SCCA. Preoperatively they were randomized to receive either sevoflurane (n = 5) or total intravenous anesthesia (n = 5). Immunohistochemistry of pre- and postprocedural tumor tissue was performed using the following markers: HIF-1A, HIF-2A, SIRT-1, mTOR, FASn, COX-2, c-MET, pAKT, NFkB, and pp38. Morphoproteomic scoring by a blinded pathologist was then employed to evaluate for differences in expression between the 2 groups.
Results:
Differential expression of several proteins was observed between the 2 groups. Specifically, sevoflurane was associated with increased protein expression in postprocedural tissue. Moreover, correlative analysis demonstrated an association between increased expression of several markers and specific tumor features (eg, perineural invasion).
Conclusions:
While only preliminary, our results suggest that the form of anesthesia used during surgery may affect the molecular biology of HNSCC. This study represents one of the first to evaluate the effects of anesthesia on the molecular biology of HNSCC in vivo. However, larger, prospective studies are needed to better evaluate the effect of anesthesia on the postoperative outcomes of HNSCC.
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