Persistent Opioid Use Following Resection of Oral Cavity Squamous Cell Carcinoma: Incidence and Risk Factors

Area of Science:

• Oncology
• Pain Management
• Surgical Outcomes

Background:

• Persistent opioid use following head and neck cancer surgery is an increasing clinical concern.
• Limited data exists on the incidence and risk factors for this issue.
• Oral cavity squamous cell carcinoma (OCSCC) represents a significant subset of head and neck cancers.

Purpose of the Study:

• To determine the incidence of persistent opioid use after primary resection for OCSCC.
• To identify independent predictors of persistent opioid use in this patient population.
• To inform strategies for early risk stratification and improved patient outcomes.

Main Methods:

• Retrospective cohort study of 430 patients undergoing OCSCC resection (2016-2022).
• Preoperative opioid use categorized as naïve, intermittent, or chronic via prescription drug monitoring data.
• Persistent use defined by specific prescription filling criteria (120-365 days postoperatively); regression analysis used for predictor identification.

Main Results:

• 18.8% of patients exhibited persistent opioid use post-surgery.
• Independent predictors included chronic preoperative opioid use, G-tube dependence at 12 months, chronic pain diagnosis, and cancer recurrence.
• The peak incidence of persistent opioid use occurred between 120 and 180 days postoperatively.

Conclusions:

• Persistent opioid use is a frequent complication after oral cancer resection.
• Preoperative opioid use is a strong, independent predictor of persistent postoperative use.
• Implementing early risk stratification models is recommended to mitigate this complication.