The Impact of Surgery on Angiogenesis

Surgical resection remains the mainstay of treatment for the vast majority of patients with primary solid tumors. However, there is evidence that the physiologic response to surgery may be a particularly dangerous one for cancer patients. In both the experimental and the human arena, several potential mechanisms by which surgical trauma might impact tumor growth have been discovered. Clinical studies have demonstrated that surgery is associated with alterations in immune function as well as plasma composition that may make the patient more susceptible to the development of tumor recurrences. It is logical to assume that the body should be primed for angiogenesis postoperatively because of the surgical wounds. This may be problematic for cancer patients since the conditions conducive to wound healing may also promote tumor growth. This article reviews the experimental evidence that suggests there is a significant increase in angiogenesis following surgical trauma and that this increase may impact long-term cancer-free survival.