Preoperative and Perioperative Analgesia/Anesthesia in Ovarian Cancer Patients: Correlation With Recurrence [36H

Abstract

INTRODUCTION: Prior breast cancer studies demonstrated an association between beta blockers and nonsteroidal medication in disease-free survival, possibly due to immune interactions. This hypothesis-generating retrospective study evaluated the association between ovarian cancer recurrence and baseline medication use (aspirin, acetaminophen, nonsteroidals, beta blockers, or antidepressants) and the perioperative medication (Tylenol, NSAIDs and regional analgesia) administration. METHODS: After IRB approval, a retrospective chart review of an academic medical center’s pathology database and ovarian cancer registry was performed to evaluate medication administration and recurrence. RESULTS: 284 women with ovarian cancer were included (mean age 62 years). At point of last contact, 34.2% were alive without recurrence, 15.7% were alive with disease, 43.1% had died of disease, and 7% unknown. 61.2% had cancer recurrence. Mean time from surgery to recurrence was 23.7 months (4.4-132.5 +/- 20). There was no statistically significant difference in baseline use of beta blockers (P=.076), aspirin (P=.29), acetaminophen (P=.67), NSAIDs (P=.78) or anti-depressants (P=.96). There was no statistically significant difference between perioperative medication use and recurrence, regional anesthesia (P=.12), beta-blocker (P=.93), acetaminophen (P=.68), and nonsteroidals (P=.12). Women who recurred were older (59.5 vs 63.7 years, P<.01) and had higher CA-125 (93.6% vs 6.4%, P<.01) at diagnosis. Of the medications evaluated, antidepressants showed the only statistically significant difference in progression free survival (PFS), (70 vs 77 months, P=.008). CONCLUSION: Outside of the association of antidepressant use with worse PFS, there was no statistically significant difference in disease recurrence based on baseline or perioperative analgesic medication use.