title: Do intraoperative analgesics influence breast cancer recurrence after mastectomy? A retrospective analysis.
abstract: BACKGROUND
  Whether intraoperative analgesics have an impact on postoperative cancer recurrence is unknown. Some investigations suggest that the opioids could favor relapse and that regional analgesia and nonsteroidal antiinflammatory drugs could improve cancer prognosis. We retrospectively reviewed our series of breast cancer surgery patients.
  
  
  METHODS
  This retrospective study included 327 consecutive women who underwent mastectomy with axillary dissection for breast cancer. The main objective was to compare the incidence of cancer recurrence among patients who received different analgesics during surgery.
  
  
  RESULTS
  Perioperative characteristics, cancer prognostic factors, and the length of surgery were comparable regardless of the analgesics administered. Univariate and multivariate analyses showed a lower cancer recurrence rate when ketorolac was given before surgery (P = 0.019). Other analgesics (sufentanil, ketamine, and clonidine) were not associated with a significant reduction in cancer recurrence rates in our series.
  
  
  CONCLUSIONS
  This retrospective analysis suggests that intraoperative administration of ketorolac decreases the risk of breast cancer relapse compared with other analgesícs.
authors.affiliation: Department of Anesthesiology, Université Catholique de Louvain, Louvain-la-Neuve, Belgium. forgetpatrice@yahoo.f
authors.forename: Patrice
authors.initials: P
authors.lastname: Forget
authors.forename: Julie
authors.initials: J
authors.lastname: Vandenhende
authors.forename: Martine
authors.initials: M
authors.lastname: Berliere
authors.forename: Jean-Pascal
authors.initials: JP
authors.lastname: Machiels
authors.forename: Benoît
authors.initials: B
authors.lastname: Nussbaum
authors.forename: Catherine
authors.initials: C
authors.lastname: Legrand
authors.forename: Marc
authors.initials: M
authors.lastname: De Kock
mesh_terms: D000328:Adult; D000368:Aged; D000700:Analgesics / Q000627:therapeutic use*; D000701:Analgesics, Opioid / Q000009:adverse effects / Q000627:therapeutic use; D000704:Analysis of Variance; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000453:epidemiology* / Q000473:pathology / Q000601:surgery*; D003625:Data Collection; D018572:Disease-Free Survival; D023381:Endpoint Determination; D005260:Female; D006801:Humans; D007430:Intraoperative Care; D053208:Kaplan-Meier Estimate; D020910:Ketorolac / Q000627:therapeutic use; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis / Q000473:pathology; D008408:Mastectomy; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local; D010149:Postoperative Pain / Q000188:drug therapy; D012044:Regression Analysis; D012189:Retrospective Studies
chemical_list: D000700:Analgesics; D000701:Analgesics, Opioid; D000894:Anti-Inflammatory Agents, Non-Steroidal; D020910:Ketorolac