Background:
Retrospective studies and meta-analyses have shown a reduction in 5-year survival following
inhalational based compared to propofol based total intravenous (TIVA) anaesthesia for cancer
surgery. To date there have been no prospective trials published which evaluate the effect of
anaesthetic technique on circulating tumour cells (CTC), oxidative stress, and recurrence
rate following cancer surgery. Children with cancer often require surgery for tumour excision
as well as for other diagnostic and therapeutic procedures. To date there has been no
prospective randomized controlled trial evaluating the optimal anaesthetic technique for
surgery on children with cancer.
Aim:
This is a pilot study in paediatric patients who require surgery for tumour excision. The aim
is to investigate the effect of sevoflurane inhalational versus propofol intravenous
anaesthesia on expression of hypoxia-inducible factor 1 (HIF-1), circulating tumour cells,
DNA damage and biomarkers of immunity and inflammation in patients before and after tumour
surgery. The patients will be followed up for up to 5 years for tumour recurrence after
surgery.
Method:
This will be a single-blinded randomized controlled trial. One hundred children undergoing
tumour excision surgery at the Hong Kong Children's Hospital will be recruited and randomized
to receive TIVA or inhalational anaesthesia. Baseline, intraoperative and postoperative blood
will be taken for tests of immunity and inflammatory markers, DNA damage and circulating
tumour cells. Patients would be followed up to 3 years for tumour recurrence and survival.