Premium
Assessing the survival impact of perioperative opioid consumption in children and adolescents undergoing cytoreductive surgery with hyperthermic intraperitoneal chemotherapy
Author(s) -
OwusuAgyemang Pascal,
HayesJordan Andrea,
Van Meter Antoinette,
Williams Uduak U.,
Zavala Acsa M.,
Kapoor Ravish,
Popovich Shan M.,
Rebello Elizabeth,
Feng Lei,
Cata Juan P.
Publication year - 2017
Publication title -
pediatric anesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.704
H-Index - 82
eISSN - 1460-9592
pISSN - 1155-5645
DOI - 10.1111/pan.13146
Subject(s) - medicine , hazard ratio , perioperative , retrospective cohort study , proportional hazards model , confidence interval , surgery , chemotherapy , opioid , hyperthermic intraperitoneal chemotherapy , univariate analysis , multivariate analysis , cancer , cytoreductive surgery , receptor , ovarian cancer
Summary Background Several studies in adult patients have suggested an unfavorable association between opioid consumption and cancer progression. Aims This study investigated the impact of opioid consumption on the survival of children and adolescents undergoing cytoreductive surgery with hyperthermic intraperitoneal chemotherapy. Methods A 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. Results Seventy‐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. Conclusion In 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.