Investigation of opioid use and long-term oncologic outcomes for non-small cell lung cancer patients treated with surgery

Abstract

Opioids are commonly used for postoperative pain control in cancer patients. In addition to pain control, an association between opioid use and long-term oncologic outcomes, such as recurrence or overall survival, has been postulated. The aim of this study was to determine whether postoperative opioid use in patients with non-small cell lung cancer is associated with long-term oncologic outcomes, including recurrence and death. Data obtained from 1009 medical records of patients who underwent curative resection at the National Cancer Center, Korea between January 2006 and December 2010 were retrospectively analyzed. Seven-day opioid use was divided into four quartiles to analyze probability of recurrence and death. Multivariate regression analyses of recurrence and death was conducted, including the calculation of odds ratios. A total of 871 patients were analyzed. When opioid dosage was examined by quartiles, the probability of death and recurrence increased gradually with increasing opioid use. However, in the multivariate regression analysis, the amount of opioid usage did not affect the risk of recurrence or death of lung cancer (P = 0.520 for recurrence; P = 0.659 for death). Opioid use was correlated with outcome when stratified by lung cancer stage (P = 0.004 for recurrence; P = 0.049 for death); however, the odds ratios only slightly increased (1.001 for stage IA–IIIA) for both outcomes. In non-small cell lung cancer patients, the amount of opioid usage does not affect the risk of recurrence and death of lung cancer. There was an association with stage (IA–IIIA), but the effect was negligible. A well-designed prospective study is needed.

Long-Term Oncologic Outcomes for Patients Undergoing Volatile Versus Intravenous Anesthesia for Non-Small Cell Lung Cancer Surgery

“…However, no epidural analgesia was used in this study due to possible complications associated with epidural catheterization. Since a high dose of opioid can influence the long-term outcome after NSCLC surgery, 16 this is an important issue to bear in mind.…”

Could the Perioperative Use of Opioids Influence Cancer Outcomes After Surgery? A Scoping Review Protocol

“…The outcomes considered, indeed, may be dependent on multiple factors such as type of opioid and dose. Literature data are for both variables con icting [18]. Moreover, it will be important to accurately extract data on the disease (stage, grading).…”

Anaesthesia as an influence in tumour progression

“…The analyses of postoperatively administered opioids have fewer confounding factors, but the subject is not feasible for a prospective design. A retrospective analysis found no correlation between the total amount of consumed opioids after curative lung cancer resection and long-term survival or recurrence rates [ 40 ]. Similar results were found in two large cohort studies on postoperative chronic opiate use after breast cancer surgery [ 41 , 42 ].…”