Intraoperative opioids use for laryngeal squamous cell carcinoma surgery and recurrence: a retrospective study

J Clin Anesth. 2015 Dec;27(8):672-9. doi: 10.1016/j.jclinane.2015.07.012. Epub 2015 Sep 12.

Abstract

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.

Keywords: Cancer recurrence; Laryngeal squamous cell carcinoma; Opioids; Surgery; Survival.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Intravenous
  • Aged
  • Analgesics, Opioid / administration & dosage*
  • Analgesics, Opioid / adverse effects
  • Carcinoma, Squamous Cell / pathology
  • Carcinoma, Squamous Cell / surgery*
  • Disease-Free Survival
  • Female
  • Head and Neck Neoplasms / pathology
  • Head and Neck Neoplasms / surgery*
  • Humans
  • Intraoperative Care
  • Laryngeal Neoplasms / pathology
  • Laryngeal Neoplasms / surgery*
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Neoplasm Recurrence, Local
  • Proportional Hazards Models
  • Retrospective Studies
  • Squamous Cell Carcinoma of Head and Neck
  • Survival Rate

Substances

  • Analgesics, Opioid