Effects of Anesthetic Methods on Hepatic Cancer Cell Function in Vitro

Shanghai Jiao Tong University

Status: Completed

Conditions: Hepatocellular Carcinoma

Treatments: Procedure: general anesthesia; Procedure: local anesthesia

Study type: Interventional

Funder types: Other

Identifiers

NCT04510935

HCCRA202008

Details and patient eligibility

About

Numerous studies find that anesthetic methods may influence the recurrence of tumor and the overall survival of patients after primary cancer surgery. Radiofrequency (RF) ablation is now widely used in the clinic for treatment of hepatocellular carcinoma (HCC). Currently, diverse anesthetic methods, including general anesthesia (GA), epidural anesthesia and local anesthesia (LA), are used for RF ablation surgery. Using serum from HCC surgery patients randomized to receive either GA or LA during surgery, we will investigate the effects of anesthetic methods on cellular invasion, migration and proliferation of HepG2 hepatic cancer cells in vitro. The expression levels of inflammatory cytokines in the serum from patients of both groups will also be analyzed.

Full description

Patients diagnosed with hepatocellular carcinoma (HCC) undergoing elective radiofrequency (RF) ablation surgery will be randomly allocated to general anesthesia(GA) group or local anesthesia(LA) group.

Patients from GA group will receive anesthesia induced with 0.05-0.1mg/kg intravenous midazolam, 3-6ug/kg fentanyl, 1.0-2.5mg/kg propofol and 0.1-0.2mg/kg atracurium. Laryngeal mask will be used to maintain ventilation. Anesthesia will be maintained with 4-8mg/kg/h propofol and 0.1-0.3ug/kg/min remifentanil, and additional non-depolarizing muscle relaxant when necessary. In patients from LA group, analgesia will be provided by a subcutaneous injection of 2% lidocaine by the surgeons before insertion of the needles.

Serum will be collected from patients of both groups at before induction and 1h post-surgery. The HepG2 hepatic cancer cell line will be treated with patient serum from both groups. The effects of anesthetic methods on cellular invasion, migration, proliferation will be measured. The expression levels of inflammatory cytokines in the serum from patients of both groups will also be analyzed.

Enrollment: 35 patients

Sex: All

Ages: 18 to 65 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• 18 to 65 years old
• ASA grade I-III
• Diagnosed with a single primary liver tumor of 3cm or smaller
• Is scheduled for elective radiofrequency ablation surgery
• With no macro-vascular invasion, no lymph node or extrahepatic metastases
• Child-Pugh Class A or B

Exclusion criteria

• a history of liver surgery previously (including radiofrequency ablation)
• severe systemic disease (heart, lung, kidney, or immune system)
• INR>1.5 or platelet count <45,000 cells/mm3
• a history of addiction to opioids;
• Disagree to participate the trial

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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35 participants in 2 patient groups

general anesthesia

Experimental group

Description:

Patients in this group will have RF ablation for treatment of HCC under general anesthesia.

Treatment:

Procedure: general anesthesia

local anesthesia

Active Comparator group

Description:

In this group, patients will receive radiofrequency ablation under local anesthesia.

Treatment:

Procedure: local anesthesia