Abstract
Whether opioid use in cancer surgery would promote tumor dissemination in humans is inconclusive. We investigated the effect of intraoperative fentanyl dose on colorectal cancer (CRC) prognosis following resection in this retrospective study. A total of 1679 patients with stage I-III CRC undergoing tumor resection between January 2011 and December 2014 were evaluated through August 2016. Postoperative recurrence-free survival (RFS) and overall survival (OS) were analyzed using Cox regression models. Multivariable Cox regression analysis demonstrated no dose-response association between the amount of fentanyl dose and RFS (adjusted hazard ratio: 1.03, 95% CI: 0.89–1.19) or OS (adjusted hazard ratio: 0.84, 95% CI: 0.64–1.09). Patients were further classified into the high- and low-dose groups by the median of fentanyl dose (3.0 μg·kg−1), and there was no significant difference in RFS or OS between groups, either (adjusted hazard ratio: 0.93, 95% CI: 0.74–1.17 for RFS; 0.79, 95% CI: 0.52–1.19 for OS). We concluded that intraoperative fentanyl consumption has no impact on recurrence-free or overall survival in patients after curative CRC resection.
Highlights
Since opioids are common analgesics administered during and after cancer surgery, it is of great importance to evaluate their effects on oncologic outcomes in clinical setting
This study showed no definite association between intraoperative fentanyl dose and oncologic outcomes in stage I-III colorectal cancer (CRC) patients after surgical resection
Despite the contradiction to the findings of some prior investigations, our study provided new evidence to reject the hypothetical relationships between intraoperative fentanyl dose and CRC prognosis after surgery with two strengths
Summary
Since opioids are common analgesics administered during and after cancer surgery, it is of great importance to evaluate their effects on oncologic outcomes in clinical setting. We conducted this retrospective cohort study in patients following CRC surgery to analyze the associations between intraoperative fentanyl dose and cancer recurrence or overall mortality using multivariable Cox regression models. Dose-response associations between the amount of fentanyl dose and cancer outcomes were further evaluated and major prognostic predictors of CRC outcomes were considered in the analysis to reduce potentially confounding effects[9,10,11]
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