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
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
UR - http://www.scopus.com/inward/record.url?scp=85065552799&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85065552799&partnerID=8YFLogxK
U2 - 10.1097/MD.0000000000015442
DO - 10.1097/MD.0000000000015442
M3 - Article
C2 - 31045812
AN - SCOPUS:85065552799
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
SN - 0025-7974
IS - 18
M1 - e15442
ER -