The effects of surgery-induced immunosuppression and angiogenesis on tumour growth.

Surgical removal of primary tumours can help in the treatment of cancer but carries the risk of triggering the proliferation of dormant micrometastases. Many experimental and clinical studies have demonstrated that anti-angiogenic mechanisms and immune surveillance are essential to inhibit metastatic tumour cells from growing. As surgical stress often induces a reduction in anti-angiogenic factors in parallel with increases in angiogenic factors and suppression of immune surveillance during the post-operative period, new strategies for peri-operative immunostimulation and chemotherapy are required. This review summarises the factors and proposed mechanisms underlying the effects of surgery on immunosuppression and angiogenesis.