NATURAL-KILLER AND LYMPHOKINE-ACTIVATED CYTOTOXICITY FOLLOWING ANESTHESIA IN PATIENTS WITH UVEAL MALIGNANT-MELANOMA

The role of enucleation in the treatment of ocular melanoma has been q uestioned by those who believe that it may increase circulating melano ma cells, increasing the incidence of metastases. Some aspects of the immune system are depressed by general anaesthesia, therefore this stu dy was initiated to assess the effect of general anaesthesia on natura l killer (NK) cell and interleukin-2 (IL-2)-activated cytotoxicity in 19 patients using Cr-51-labelled target cells (K 562 and SW 742). NK c ytotoxicity 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 com pared 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 com pared with that in patients with smaller tumours. IL-2-stimulated cyto toxicity was reduced at 1 day post-surgery in females only. There was an increased IL-2-stimulated cytotoxicity at induction when propofol w as used and IL-2-stimulated cytotoxicity was reduced at 1 week post-op eratively if the patient's mean tumour diameter was > 15.0 mm. If NK c ell and lymphokine-stimulated cell cytotoxicity are involved in limiti ng metastatic disease, the patient' sex and tumour size and the anaest hetic agent used may influence the survival rates following surgery.