Does postoperative morphine consumption for acute surgical pain impact oncologic outcomes after colorectal cancer resection? A retrospective cohort study

Hsiang Ling Wu, Ying Hsuan Tai, Wen Kuei Chang, Kuang Yi Chang, Mei Yung Tsou, Yih Giun Cherng, Shih Pin Lin

Research output: Contribution to journalArticle

1 Citation (Scopus)


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.

Original languageEnglish
Article numbere15442
JournalMedicine (United States)
Issue number18
Publication statusPublished - May 1 2019



  • cancer surgery
  • metastasis
  • opioid
  • recurrence
  • Tertiary Care Centers
  • Humans
  • Middle Aged
  • Proportional Hazards Models
  • Male
  • Morphine/administration & dosage
  • Disease Progression
  • Dose-Response Relationship, Drug
  • Colorectal Neoplasms/mortality
  • Analgesia, Patient-Controlled/methods
  • Survival Analysis
  • Aged, 80 and over
  • Female
  • Aged
  • Retrospective Studies
  • Analgesics, Opioid/administration & dosage
  • Neoplasm Staging
  • Pain, Postoperative/drug therapy

ASJC Scopus subject areas

  • Medicine(all)

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