Assessing the survival impact of perioperative opioid consumption in children and adolescents undergoing cytoreductive surgery with hyperthermic intraperitoneal chemotherapy

Male Reoperation Adolescent Carcinoma Infant Antineoplastic Agents Cytoreduction Surgical Procedures Hyperthermia, Induced Prognosis Combined Modality Therapy Disease-Free Survival Perioperative Care 3. Good health Analgesics, Opioid 03 medical and health sciences 0302 clinical medicine Child, Preschool Disease Progression Humans Pain Management Female Child Peritoneal Neoplasms
DOI: 10.1111/pan.13146 Publication Date: 2017-04-17T07:27:42Z
ABSTRACT
SummaryBackgroundSeveral studies in adult patients have suggested an unfavorable association between opioid consumption and cancer progression.AimsThis study investigated the impact of opioid consumption on the survival of children and adolescents undergoing cytoreductive surgery with hyperthermic intraperitoneal chemotherapy.MethodsA retrospective study of patients <19 years who had undergone cytoreductive surgery with hyperthermic intraperitoneal chemotherapy was performed. Univariate and multivariate Cox proportional hazard analyses were used to identify factors associated with recurrence‐free survival and overall survival.ResultsSeventy‐five patients were identified. Median age was 11.6 years (range, 1.8–18.9), and 43% was female. Median perioperative opioid consumption was 18.9 morphine dose equivalents per kilogram (range, 0.6–339.6). There was no statistically significant association between opioid consumption and recurrence‐free survival [hazard ratio, 1.00; 95% confidence interval, (0.99–1.02), P = 0.55] or overall survival [hazard ratio 1.01; 95% confidence interval (0.99–1.03), P = 0.22]. Independent prognostic factors associated with poor survival included incomplete cytoreduction and extra‐abdominal disease.ConclusionIn this retrospective study of children and adolescents who had undergone cytoreductive surgery with hyperthermic intraperitoneal chemotherapy, there was no statistically significant association between opioid consumption and recurrence‐free survival or overall survival.
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