Care of the immunocompromised cancer patient in the perioperative period: Narrative review

Abstract

Cancer is emerging as a significant global public health concern. Worldwide, the incidence of cancer is predicted to increase by 50% by the year 2030. Over 80% of patients will need anaesthetic care and services for perioperative and periprocedural care, as well as for other non-cancer-related procedures. It is estimated that by 2030, over 45 million surgical procedures will be needed globally for cancer control alone. Immunosuppressed patients with cancer represent a unique subset of the population who are at a heightened risk of developing severe infections due to neutropenia, lymphopenia, and immune impairment. The complex nature of the deranged immunologic profiles, compounded by using immune-altering therapies (e.g. corticosteroids, cytotoxic drugs, and immunotherapy) during the perioperative period and after the index surgical procedure, increases the risk of various complications and unfavourable cancer-related outcomes. Therefore, understanding and addressing the unique needs of cancer patients with immune compromise is crucial for improving their prognosis and overall survival rates.