The Role of Dexmedetomidine in Tumor-Progressive Factors in the Perioperative Period and Cancer Recurrence: A Narrative Review

Dexmedetomidine, a specific alpha 2 adrenergic receptor agonist, is highly frequently used in the perioperatively for its favorable pharmacology, such as mitigating postoperative cognitive dysfunction. Increasing attention has been recently focused on the effect of whether dexmedetomidine influences cancer recurrence, which urges the discussion of the role of dexmedetomidine in tumor-progressive factors. The pharmacologic characteristics of dexmedetomidine, the tumor-progressive factors in the perioperative period, and the relationships between dexmedetomidine and tumor-progressive factors were described in this review. Available evidence suggests that dexmedetomidine could reduce the degree of immune function suppression, such as keeping the number of CD3+ cells, NK cells, CD4+/CD8+ ratio, and Th1/Th2 ratio stable and decreasing the level of proinflammatory cytokine (interleukin 6 and tumor necrosis factor-alpha) during cancer operations. However, dexmedetomidine exhibits different roles in cell biological behavior depending on cancer cell types. The conclusions on whether dexmedetomidine would influence cancer recurrence could not be currently drawn for the lack of strong clinical evidence. Therefore, this is still a new area that needs further exploration.

Automated summary

The review describes the pharmacologic characteristics of dexmedetomidine, the tumor-progressive factors during the perioperative period, and the relationships between dexmedetomidine and tumor-progressive factors. Available evidence suggests that dexmedetomidine may reduce immune function suppression during cancer operations and decrease the level of proinflammatory cytokines. However, the role of dexmedetomidine in cancer cell behavior varies depending on the cell type. Currently, there is a lack of strong clinical evidence to determine whether dexmedetomidine influences cancer recurrence.