TY - JOUR
T1 - Does postoperative morphine consumption for acute surgical pain impact oncologic outcomes after colorectal cancer resection?
T2 - A retrospective cohort study
AU - Wu, Hsiang Ling
AU - Tai, Ying Hsuan
AU - Chang, Wen Kuei
AU - Chang, Kuang Yi
AU - Tsou, Mei Yung
AU - Cherng, Yih Giun
AU - Lin, Shih Pin
N1 - Funding Information:
This work was supported by the grants from Taipei Veterans General Hospital (V104B-009), Taipei, Taiwan, R.O.C., Ministry of Science and Technology (MOST104-2314-B-075-015), Taipei, Taiwan, R.O.C., and Anesthesiology Research and Development Foundation (ARDF10401), Taipei, Taiwan, R.O.C.
Funding Information:
Funding: This work was supported by the grants from Taipei Veterans General Hospital (V104B-009), Taipei, Taiwan, R.O.C., Ministry of Science and Technology (MOST104-2314-B-075-015), Taipei, Taiwan, R.O.C., and Anesthesiology Research and Development Foundation (ARDF10401), Taipei, Taiwan, R.O.C. The authors have no conflicts of interest to disclose. aDepartment of Anesthesiology, Taipei Veterans General Hospital, bSchool of Medicine, National Yang-Ming University, Taipei, cDepartment of Anesthesiology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, dDepartment of Anesthesiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, eTaipei Municipal Gan-Dau Hospital, Taipei, Taiwan. ∗Correspondence: Shih-Pin Lin, Department of Anesthesiology, Taipei Veterans General Hospital, No. 201, Sec. 2, Shih-pai Rd., Taipei 11217, Taiwan (e-mail: splin3@vghtpe.gov.tw).
Publisher Copyright:
© 2019 the Author(s). Published by Wolters Kluwer Health, Inc.
PY - 2019/5/1
Y1 - 2019/5/1
N2 - Whether morphine used in human cancer surgery would exert tumor-promoting effects is unclear. This study aimed to investigate the effects of morphine dose on cancer prognosis after colorectal cancer (CRC) resection.In a retrospective study, 1248 patients with stage I through IV CRC undergoing primary tumor resections and using intravenous patient-controlled analgesia for acute surgical pain at a tertiary center between October 2005 and December 2014 were evaluated through August 2016. Progression-free survival (PFS) and overall survival (OS) were analyzed using proportional hazards regression models.Multivariable analysis demonstrated no dose-dependent association between the amount of morphine dose and PFS (adjusted hazard ratio, HR=1.31, 95% confidence interval, CI=0.85-2.03) or OS (adjusted HR=0.86, 95% CI=0.47-1.55). Patients were further classified into the high-dose and low-dose groups by the median of morphine consumption (49.7mg), and the morphine doses were mean 75.5 ± standard deviation 28.8mg and 30.1±12.4mg in high-dose and low-dose groups, respectively. Multivariable models showed no significant difference in PFS or OS between groups, either (adjusted HR=1.24, 95% CI=0.97-1.58 for PFS; adjusted HR=1.01, 95% CI=0.71-1.43 for OS).Our results did not support a definite association between postoperative morphine consumption and cancer progression or all-cause mortality in patients following CRC resection.
AB - Whether morphine used in human cancer surgery would exert tumor-promoting effects is unclear. This study aimed to investigate the effects of morphine dose on cancer prognosis after colorectal cancer (CRC) resection.In a retrospective study, 1248 patients with stage I through IV CRC undergoing primary tumor resections and using intravenous patient-controlled analgesia for acute surgical pain at a tertiary center between October 2005 and December 2014 were evaluated through August 2016. Progression-free survival (PFS) and overall survival (OS) were analyzed using proportional hazards regression models.Multivariable analysis demonstrated no dose-dependent association between the amount of morphine dose and PFS (adjusted hazard ratio, HR=1.31, 95% confidence interval, CI=0.85-2.03) or OS (adjusted HR=0.86, 95% CI=0.47-1.55). Patients were further classified into the high-dose and low-dose groups by the median of morphine consumption (49.7mg), and the morphine doses were mean 75.5 ± standard deviation 28.8mg and 30.1±12.4mg in high-dose and low-dose groups, respectively. Multivariable models showed no significant difference in PFS or OS between groups, either (adjusted HR=1.24, 95% CI=0.97-1.58 for PFS; adjusted HR=1.01, 95% CI=0.71-1.43 for OS).Our results did not support a definite association between postoperative morphine consumption and cancer progression or all-cause mortality in patients following CRC resection.
KW - cancer surgery
KW - metastasis
KW - opioid
KW - recurrence
KW - Tertiary Care Centers
KW - Humans
KW - Middle Aged
KW - Proportional Hazards Models
KW - Male
KW - Morphine/administration & dosage
KW - Disease Progression
KW - Dose-Response Relationship, Drug
KW - Colorectal Neoplasms/mortality
KW - Analgesia, Patient-Controlled/methods
KW - Survival Analysis
KW - Aged, 80 and over
KW - Female
KW - Aged
KW - Retrospective Studies
KW - Analgesics, Opioid/administration & dosage
KW - Neoplasm Staging
KW - Pain, Postoperative/drug therapy
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U2 - 10.1097/MD.0000000000015442
DO - 10.1097/MD.0000000000015442
M3 - Article
C2 - 31045812
AN - SCOPUS:85065552799
SN - 0025-7974
VL - 98
JO - Medicine; analytical reviews of general medicine, neurology, psychiatry, dermatology, and pediatries
JF - Medicine; analytical reviews of general medicine, neurology, psychiatry, dermatology, and pediatries
IS - 18
M1 - e15442
ER -
