The impact of intraoperative opioid use on survival after oral cancer surgery

Patiño, Miguel; Ramírez, Rafael; Pérez, Carlos A.; Feng, Lei; Kataria, Pranav; Myers, Jeffrey N.; Cata, Juan P.

doi:10.1016/j.oraloncology.2017.09.006

Cited by 31 publications

(26 citation statements)

References 28 publications

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“…Similarly, MOR agonists and naltrexone did not affect the malignant behaviors of SCC-1 cells (Zagon et al, 2007). These in vitro experiments are somewhat contradictory to recent clinical studies suggesting that the administration of opioids in the context of surgery and advanced disease are associated with cancer progression in patients with head and neck cancers (Patino et al, 2017;Silver et al, 2019a). Furthermore, Shoffel-Havakuk et al demonstrated that heroin use independently increased the risk of supraglottic squamous cell carcinoma (Shoffel-Havakuk et al, 2017).…”

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confidence: 92%

Low doses of methylnaltrexone inhibits head and neck squamous cell carcinoma growth in vitro and in vivo by acting on the mu‐opioid receptor

Görür

Patiño

Corrales

et al. 2021

Journal Cellular Physiology

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The Mu-opioid receptor (MOR) has been implicated in tumorigenesis and metastasis. Methylnaltrexone (MNTX), an antagonist of MOR, has shown to inhibit tumor growth and metastasis in lung cancer cell lines. The effect of MNTX on other cell lines such as head and neck squamous cell carcinoma (HNSCC) has not been investigated. We measured the expression and activity of the receptor in different HNSCC cell lines.Then, we evaluated the impact of modulating the expression MOR and the effect of MNTX on the proliferation, clonogenic activity, invasion, and migration of two HNSCC (FaDu and MDA686Tu) cell lines expressing MOR and one cell line (UMSCC47) not expressing the receptor. We also evaluated the impact of MNTX on tumor growth and metastasis formation in vivo. Activation of the receptor with [D-Ala2,N-Me-Phe4, Gly5ol] (DAMGO) caused a significant reduction in cyclic adenosine monophosphate levels in FaDu cells. Knockdown of MOR inhibited in vitro aggressive cell behaviors on FaDu and MDA686Tu cells and correlated with a reduction in markers of epithelial-mesenchymal transition. In vitro studies showed that MNTX strongly inhibited the proliferation, clonogenic activity, invasion, and migration of FaDu and MDA686Tu cells but has no effect on UMSCC47 cells. In vivo experiments demonstrated that MNTX suppresses tumor growth in HNSCC cell tumor-bearing mice. Our studies indicate that MOR could be considered as a therapeutic target to treat HNSCC.

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confidence: 92%

Low doses of methylnaltrexone inhibits head and neck squamous cell carcinoma growth in vitro and in vivo by acting on the mu‐opioid receptor

Görür

Patiño

Corrales

et al. 2021

Journal Cellular Physiology

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“…Oral cancer (OC) is one of the most widely prevalent head and neck cancers, characterized by high mortality rates, low long‐term survival, and increasing incidence in the developing than developed countries 1,2. Surgical resection and chemoradiotherapy are considered as the most important treatment method for OC3,4,5; however, the 5‐year survival after surgical resection was still poor 6-11. It is important to find accurate clinical staging and identification of prognostic factors for estimating prognosis and selecting appropriate treatment modalities 12,13,14,15…”

Section: Introductionmentioning

confidence: 99%

Prognostic role of platelet‐to‐lymphocyte ratio in oral cancer: A meta‐analysis

Zhang

Zheng

Quan

et al. 2019

J Oral Pathology Medicine

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Background and objective Platelet‐to‐lymphocyte ratio (PLR) has been suggested to be associated with the progression of oral cancer with inconclusive results. The objective of the current study was to assess the prognostic role of oral cancer by meta‐analysis. Method PubMed, EMbase(Ovid), CNKI, WanFang Data, VIP, and CBM databases were searched up to August 24, 2018. Studies investigating the association between PLR and progression of oral cancer were included. Meta‐analysis was performed by using Revman 5.3 software. The protocol of the study was registered on PROSPERO (CRD42018106836). Results A total of five studies were included in the meta‐analysis. The results of the meta‐analysis showed that higher PLR was associated with the poor progress of oral cancer (overall survival: OR = 2.06, 95 CI: 1.49‐2.86, P < 0.0001; disease‐specific survival: OR = 2.12, 95 CI: 1.59‐2.82, P < 0.00001). Conclusion The current meta‐analysis showed that higher PLR is a poor progression factor for oral cancer. However, larger sample, multi‐center studies should be carried out in the future to validate the above conclusion.

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“…The relationship between intraoperative anesthesia care and cancer recurrence remains under investigation with studies examining the role of opioids demonstrating controversial or conflicting results. [32][33][34] In lung and colon cancer models, exogenous opioids have been implicated through direct stimulation of the µ-opioid receptor, vascular endothelial growth factor, and increased angiogenesis. 1,6,35 Morphine increases COX-2, PGE2, and angiogenesis in breast cancer mouse models.…”

Section: Discussionmentioning

confidence: 99%

Intrathecal Morphine Administration Does Not Affect Survival After Liver Resection for Hepatocellular Carcinoma

DeMaría

Katz

Tabrizian

et al. 2019

Semin Cardiothorac Vasc Anesth

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Introduction. Opioids may influence tumor recurrence and cancer-free survival in hepatocellular carcinoma (HCC). The relationship between intrathecal morphine administration, tumor recurrence, and patient survival after hepatectomy for HCC is unknown. Patients and Methods. This single-center, retrospective study included 1837 liver resections between July 2002 and December 2012; 410 cases were incorporated in the final univariate and multivariate analysis. Confirmatory propensity matching yielded 65 matched pairs (intrathecal morphine vs none). Primary outcomes were recurrence of HCC and survival. Secondary outcomes included characterization of factors associated with recurrence and survival. Results. Groups were similar except for increased coronary artery disease in the no intrathecal morphine group. All patients received volatile anesthesia. Compared with no intrathecal morphine (N = 307), intrathecal morphine (N = 103) was associated with decreased intraoperative intravenous morphine administration (median difference = 12.5 mg; 95% confidence interval [CI] = 5-20 mg). There was no difference in blood loss, transfusion, 3- or 5-year survival, or recurrence in the univariate analysis. Multivariate analysis identified covariates that significantly correlated with 5-year survival: intrathecal morphine (hazard ratio [HR] = 0.527, 95% CI = 0.296-0.939), lesion diameter (HR = 1.099, 95% CI = 1.060-1.141), vascular invasion (HR = 1.658, 95% CI = 1.178-2.334), and satellite lesions (HR = 2.238, 95% CI = 1.447-3.463). Survival analysis on the propensity-matched pairs did not demonstrate a difference in 5-year recurrence or survival. Discussion and Conclusion. Multivariate analysis revealed a significant association between intrathecal morphine and 5-year survival. This association did not persist after propensity matching. The association between intrathecal morphine and HCC recurrence and survival remains unclear and prospective work is necessary to determine whether an association exists.

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The impact of intraoperative opioid use on survival after oral cancer surgery

Cited by 31 publications

References 28 publications

Low doses of methylnaltrexone inhibits head and neck squamous cell carcinoma growth in vitro and in vivo by acting on the mu‐opioid receptor

Low doses of methylnaltrexone inhibits head and neck squamous cell carcinoma growth in vitro and in vivo by acting on the mu‐opioid receptor

Prognostic role of platelet‐to‐lymphocyte ratio in oral cancer: A meta‐analysis

Intrathecal Morphine Administration Does Not Affect Survival After Liver Resection for Hepatocellular Carcinoma

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