Effects of Intraoperative Opioid Use on Recurrence-Free and Overall Survival in Patients With Esophageal Adenocarcinoma and Squamous Cell Carcinoma

Du, Kim; Feng, Lei; Newhouse, Abigail; Mehta, J M; Lasala, Javier; Mena, Gabriel E.; Hofstetter, Wayne L.; Cata, Juan P.

doi:10.1213/ane.0000000000003428

Cited by 46 publications

(32 citation statements)

References 30 publications

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“…In previous studies equivalent morphine consumption has contradictory impact upon disease free survival. While it decreased survival on early stages of lung cancer [38] had no impact on colorectal or esophageal cancers [30,39,40].…”

Section: Discussionmentioning

confidence: 99%

Mu Opioid Receptor 1 (MOR-1) Expression in Colorectal Cancer and Oncological Long-Term Outcomes: A Five-Year Retrospective Longitudinal Cohort Study

Díaz‐Cambronero

Mazzinari

Giner

et al. 2020

Cancers

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Preclinical evidence has shown increased expression of mu opioid receptor 1 (MOR-1) in colorectal cancer although its association with disease-free and overall survival (DFS and OS) has not been investigated. We hypothesized that MOR-1 was overexpressed in tumor samples compared to normal tissue and this was associated with decreased DFS and OS. We carried out a retrospective study assessing the association of MOR-1 tumor expression with long-term outcomes by immunohistochemistry in normal and tumor samples from 174 colorectal cancer patients. The primary endpoint was five years of DFS. Secondary endpoints were five years of OS, the difference in MOR-1 expression between normal and tumor tissue and the occurrence of postoperative complications. Multivariable Cox regression showed no significant association between MOR-1 expression and DFS (HR 0.791, 95% CI 0.603–1.039, p = 0.092). MOR-1 expression was higher in tumor tissue compared to non-tumor tissue. No associations were found between MOR-1 expression and OS or postoperative complications. These findings suggest that although MOR-1 is over-expressed in colorectal cancer samples there is no association to increased risk of recurrence or mortality. Future studies are warranted to elucidate the role of cancer stage, genetic polymorphism, and quantitative assessment of MOR-1 over-expression on long-term outcomes in colorectal cancer.

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Section: Discussionmentioning

confidence: 99%

Mu Opioid Receptor 1 (MOR-1) Expression in Colorectal Cancer and Oncological Long-Term Outcomes: A Five-Year Retrospective Longitudinal Cohort Study

Díaz‐Cambronero

Mazzinari

Giner

et al. 2020

Cancers

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“…Those authors suggested that opioids may exert different outcomes, depending on the type of histologic cancer. 49 Our study did not differentiate the cancers based on histology. We had relatively low numbers of patients diagnosed with esophageal cancer (n = 2311), and the numbers may be insufficient to demonstrate any significant finding.…”

Section: Discussionmentioning

confidence: 61%

The association of prescription opioid use with incident cancer: A Surveillance, Epidemiology, and End Results‐Medicare population‐based case‐control study

Havidich

Weiss

Onega

et al. 2020

Cancer

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BACKGROUND: Cancer is the second leading cause of death globally, and researchers seek to identify modifiable risk factors Over the past several decades, there has been ongoing debate whether opioids are associated with cancer development, metastasis, or recurrence. Basic science, clinical, and observational studies have produced conflicting results. The authors examined the association between prescription opioids and incident cancers using the Surveillance, Epidemiology, and End Results (SEER)-Medicare database. A complex relation was observed between prescription opioids and incident cancer, and cancer site may be an important determinant. METHODS: By using linked SEER cancer registry and Medicare claims from 2008 through 2013, a case-control study was conducted examining the relation between cancer onset and prior opioid exposure. Logistic regression was used to account for differences between cases and controls for 10 cancer sites. RESULTS: Of the population studied (n = 348,319), 34% were prescribed opioids, 79.5% were white, 36.9% were dually eligible (for both Medicare and Medicaid), 13% lived in a rural area, 52.7% had ≥1 comorbidity, and 16% had a smoking-related diagnosis. Patients exposed to opioids had a lower odds ratio (OR) associated with breast cancer (adjusted OR, 0.96; 95% CI, 0.92-0.99) and colon cancer (adjusted OR, 0.90; 95% CI, 0.86-0.93) compared with controls. Higher ORs for kidney cancer, leukemia, liver cancer, lung cancer, and lymphoma, ranging from lung cancer (OR, 1.04; 95% CI, 1.01-1.07) to liver cancer (OR, 1.19; 95% CI, 1.08-1.31), were present in the exposed population. CONCLUSIONS: The current results suggest that an association exists between prescription opioids and incident cancer and that cancer site may play an important role. These findings can direct future research on specific patient populations that may benefit or be harmed by prescription opioid exposure.

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“…A single injection of 1 -3 mg morphine was performed through the epidural catheter in some patients. The total dose of opioids including remifentanil, fentanyl, and morphine was expressed by fentanyl equivalents (FE) as previously described [16]. Rocuronium was administered based on train-of-four monitoring.…”

Section: Methodsmentioning

confidence: 99%

Perioperative Patient Factors Related to 2-Year Outcome after Esophageal Cancer Surgery: A Retrospective Cohort Study

Hasegawa-Moriyama¹,

Kanmura²

2020

OJAnes

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Background: Surgical treatment for esophageal cancer is major invasive surgery. Recently, opioids have been implicated in the promotion of cancer recurrence and metastasis because of their immunosuppressive effects. However, it has not been fully evaluated whether the intraoperative use of opioids is directly correlated with postoperative prognosis in the clinical setting. Therefore, this study aimed to identify perioperative factors related to postoperative complications and 2-year survival in patients undergoing esophageal cancer surgery. Methods: We retrospectively reviewed 105 patients who underwent surgery for esophageal cancer at Kagoshima University Hospital from January 2013 to December 2017. Patient parameters were compared between survivors and non-survivors for 2 years after surgery. Results: The 2-year survival rate after esophageal cancer surgery was 76.2% (80 survivors vs. 25 non-survivors). The incidence of postoperative pneumonia within 7 days after surgery was significantly higher in non-survivors compared with survivors (36.0% vs. 16.3%; odds ratio, 2.90; 95% confidence interval, 1.06-7.96, P < 0.05). Pneumonia was associated with postoperative metastasis (odds ratio, 3.00; 95% confidence interval, 1.117-8.072, P = 0.029). The intraoperative dosage of opioids calculated as fentanyl equivalents was not correlated with any postoperative complications or 2-year survival. The preoperative albumin level and neutrophil-lymphocyte ratio were associated with the incidence of postoperative pneumonia. Conclusions: Postoperative pneumonia may be a possible predictor of 2-year prognosis in patients after esophageal cancer surgery, and is not correlated with intraoperative use of opioids. Preoperative physical status including immune and nutrient states may be more important for postoperative prognosis after esophageal cancer surgery.

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Effects of Intraoperative Opioid Use on Recurrence-Free and Overall Survival in Patients With Esophageal Adenocarcinoma and Squamous Cell Carcinoma

Cited by 46 publications

References 30 publications

Mu Opioid Receptor 1 (MOR-1) Expression in Colorectal Cancer and Oncological Long-Term Outcomes: A Five-Year Retrospective Longitudinal Cohort Study

Mu Opioid Receptor 1 (MOR-1) Expression in Colorectal Cancer and Oncological Long-Term Outcomes: A Five-Year Retrospective Longitudinal Cohort Study

The association of prescription opioid use with incident cancer: A Surveillance, Epidemiology, and End Results‐Medicare population‐based case‐control study

Perioperative Patient Factors Related to 2-Year Outcome after Esophageal Cancer Surgery: A Retrospective Cohort Study

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