No association of postoperative opioid usage with long-term surgery outcomes in patients with liver cancer: a population-based retrospective cohort study

被引:2
|
作者
Yeh, Pin-Hung [1 ,2 ]
Yeh, Han-Wei [3 ,4 ]
Yang, Shun-Fa [1 ,5 ]
Wang, Yu-Hsun [5 ]
Chou, Ming-Chih [1 ,6 ]
Tsai, Ping-Kun [7 ]
Yeh, Chao-Bin [1 ,8 ,9 ]
机构
[1] Chung Shan Med Univ, Inst Med, Taichung, Taiwan
[2] Changhua Christian Hosp, Dept Anesthesiol, Changhua, Taiwan
[3] Chang Gung Univ, Sch Med, Taoyuan, Taiwan
[4] Chang Gung Mem Hosp, Med Educ Dept, Taoyuan, Taiwan
[5] Chung Shan Med Univ Hosp, Dept Med Res, Taichung, Taiwan
[6] Chung Shan Med Univ Hosp, Dept Surg, Taichung, Taiwan
[7] Kaohsiung Armed Forces Gen Hosp, Dept Internal Med, Zuoying Branch, Kaohsiung, Taiwan
[8] Chung Shan Med Univ, Sch Med, Dept Emergency Med, 110,Sect 1, Chien Kuo N Rd, Taichung, Taiwan
[9] Chung Shan Med Univ Hosp, Dept Emergency Med, Taichung, Taiwan
关键词
Hepatocellular carcinoma; Perioperative care; Opioids; Survival; Recurrence; THORACIC EPIDURAL ANALGESIA; LUNG-CANCER; HEPATOCELLULAR-CARCINOMA; RECURRENCE; PAIN; SURVIVAL;
D O I
10.1097/j.pain.0000000000002776
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
Hepatocellular carcinoma (HCC) is a fatal cancer worldwide, and surgical resection remains the standard treatment. Postoperative opioid prescription has been believed to affect cancer recurrence through complex biological pathways. We conducted a retrospective cohort study using the Longitudinal Health Insurance Database of Taiwan to evaluate the relationship between postoperative opioid use and long-term surgical outcomes of patients with HCC. This study had a retrospective cohort design. In total, 812 patients older than 20 years who underwent hepatectomy because of HCC were included. The exposure group comprised patients who used opioids during hospitalization postoperatively. The comparison group included those who never used opioids during hospitalization postoperatively. A Cox proportional hazards model was used to evaluate the overall survival or recurrence-free survival rate between the opioid group and the nonopioid group. A total of 530 patients received opioids postoperatively and 282 patients did not. The hazard ratios of overall survival and recurrence-free survival were 1.10 (95% confidence interval [CI], 0.85-1.41) and 1.15 (95% CI, 0.91-1.46), respectively. Total postoperative opioids were converted into oral morphine milligram equivalents and then divided into 3 equal subgroups: low dose, <40 mg; medium dose, 40 to 144 mg; and high dose, >= 145 mg. The hazard ratios of overall survival were 0.88 (95% CI, 0.63-1.24) for the low-dose group, 1.27 (95% CI, 0.92-1.74) for the medium-dose group, and 1.14 (95% CI, 0.83-1.58) for the high-dose group. Postoperative opioids do not affect overall and recurrence-free survival in patients undergoing hepatectomy or liver transplantation because of HCC. Cancer recurrence should not be a clinical concern regarding postoperative opioid prescription.
引用
收藏
页码:848 / 854
页数:7
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