Natural killer and lymphokine-activated cytotoxicity following anaesthesia in patients with uveal malignant melanoma.

Abstract

The role of enucleation in the treatment of ocular melanoma has been questioned by those who believe that it may increase circulating melanoma cells, increasing the incidence of metastases. Some aspects of the immune system are depressed by general anaesthesia, therefore this study was initiated to assess the effect of general anaesthesia on natural killer (NK) cell and interleukin-2 (IL-2)-activated cytotoxicity in 19 patients using 51Cr-labelled target cells (K 562 and SW 742). NK cytotoxicity was increased at induction and during the operation which was due to significant increases in female, but not male patients. At 1 week post-surgery, female patients had decreased NK cytotoxicity compared with males at this interval. NK cytotoxicity compared with males at this interval. NK cytotoxicity was increased intra-operatively when alfentanyl was used, and if the mean tumour diameter was > 15.0 mm the NK cytotoxicity was increased intra-operatively compared with that in patients with smaller tumours. IL-2-stimulated cytotoxicity was reduced at 1 day post-surgery in females only. There was an increased IL-2-stimulated cytotoxicity at induction when propofol was used and IL-2-stimulated cytotoxicity was reduced at 1 week post-operatively if the patient's mean tumour diameter was > 15.0 mm. If NK cell and lymphokine-stimulated cell cytotoxicity are involved in limiting metastatic disease, the patient' sex and tumour size and the anaesthetic agent used may influence the survival rates following surgery.