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Intraoperative opioids use for laryngeal squamous cell carcinoma surgery and recurrence: a retrospective study
Juan P Cata1, Mark Zafereo2, John Villarreal3
1Department of Anaesthesiology and Perioperative Medicine, The University of Texas MD Anderson Cancer Centre, Houston, TX, USA; Anesthesia and Surgical Oncology Research Group. Houston, TX, USA.
Study Objective:
To assess whether the use of intraoperative opioids is associated with poor recurrence-free survival (RFS) and overall survival (OS) after lung cancer surgery.
Design:
Retrospective study.
Setting:
Academic hospital.
Subjects:
Patients with laryngeal primary or recurrent laryngeal squamous cell carcinoma who had surgery.
Interventions:
Intravenous opioids (remifentanil, fentanyl, sufentanil, and hydromorphone).
Measurements:
Univariate and multicovariate Cox proportional hazards models were applied to assess the effects of covariates of interest on OS and RFS.
Main Results:
A total of 195 patients were included. All received opioids intraoperatively. The multivariate analysis demonstrated that age (hazard ratio [HR], 1.03; P = .005), negative margin status (HR, 0.163; P = .001], postoperative chemotherapy (HR, 7.38; P < .001), and concurrent chemotherapy and radiation (HR, 3.11; P < .001) treatment and fentanyl equivalent use (HR, 1.001; P = .02) were all predictor factors for 3- and 5-year RFS. The same variables were predictor factors for OS (age: HR, 1.03 [P = .003]; negative margin status: HR, 0.14 [P = .001]; postoperative chemotherapy: HR, 4 [P < .0001]; and fentanyl equivalent use: HR, 1.001 [P = .02]).
Conclusions:
Our study demonstrates a very weak association between the use of intraoperative opioids and cancer recurrence after laryngeal squamous cell carcinoma surgery.
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