Correlation of Immune Parameters in Breast Cancer Patients Undergoing General Anesthesia: post-hoc Analysis of the TeMP Study

Aim: to study the correlation of immune parameters in breast cancer patients undergoing general anesthesia and to evaluate the 1-year overall and recurrence-free survival after surgery depending on general anesthesia technique.

Materials and Methods. A post hoc analysis of data from a double-blind, randomized, controlled clinical trial involving 98 patients with operable breast cancer was performed. Patients were divided into two groups: 48 received inhalational anesthesia (IA) and 50 received total intravenous anesthesia (TIVA). Immune parameters (CRP, IgA, IgM, IgG, C3, C4, MMP-9, neutrophil and lymphocyte counts, etc.) were assessed before induction of anesthesia, 1 hour postoperatively, and 24 hours postoperatively. Spearman correlation coefficients and heat maps were used for analysis.

Results. In the IA group, significant uniform increases were observed in all immunoglobulin types at 1 and 24 hours postoperatively (all P<0.001; for IgA-IgG, R=0.928; for IgA-IgM, R=0.837; for IgG-IgM, R=0.815). A positive correlation was found between complement components (C3, C4) and immunoglobulins (P=0.011 — 0.023; R=0.313–0.363). In the TIVA group, changes were variable: immunoglobulin levels increased at 1 hour (P<0.001) but decreased at 24 hours (P<0.001). A strong positive correlation was identified between cytotoxic T cells and NK cells (P0.001; R=0.722). Neutrophil count showed no significant correlation with cytotoxic T or NK cells. One year after surgery, both groups demonstrated 100% overall and recurrence-free survival.

Conclusion. IA was associated with synchronized changes in humoral immunity components, whereas TIVA resulted in variable immune responses, suggesting potential differences in IA and TIVA effects on the immune system. However, no impact of anesthesia technique on overall or recurrence-free survival was observed. More research is needed to better understand how different anesthetics affect immune function and the potential impact of anesthesia technique on long-term cancer outcomes.

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