title: Opioid needs of terminally ill patients with gynecologic malignancies.
abstract: BACKGROUND
  Little is known about patterns and predictive factors regarding opioid use for terminally ill patients with gynecologic malignancies. The aim of this study was to elucidate predictors affecting opioid requirements of end-of-life patients with gynecologic malignancies.
  
  
  METHODS
  A retrospective study was carried out on patients with gynecological malignancies admitted to our institute and died during the years 2002 to 2012. The association between maximum opioid dose and factors affecting opioid requirements were examined. Data extracted from medical records included age, site of primary cancer, maximum total dose of opioids prescribed over 24 h, the site of recurrence and metastasis, procedures performed during the hospital stay, total number of chemotherapy courses and overall survival.
  
  
  RESULTS
  The study identified 189 patients. Most patients had ovarian cancer (42.3 %) followed by cervical cancer (28.0 %) and then corpus malignancy (27.0 %). Opioid requirements decreased with increasing age, especially from the 50s onward. This was particularly marked in cervical cancer patients. In addition, pelvic metastasis was associated with the maximum dose of opioids and the average opioid use was highest in patients with cervical cancer.
  
  
  CONCLUSIONS
  Young age and pelvic invasion were significant predictive factors regarding opioid requirements. Additionally, cervical cancer patients may require more opioids among those with gynecologic malignancies.
authors.affiliation: Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Tsuruma-cho 65, Showa-ku, Nagoya, 466-8550, Japan.
authors.forename: Fumi
authors.initials: F
authors.lastname: Utsumi
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Kajiyama
authors.forename: Jun
authors.initials: J
authors.lastname: Sakata
authors.forename: Makiko
authors.initials: M
authors.lastname: Higashi
authors.forename: Kaoru
authors.initials: K
authors.lastname: Niimi
authors.forename: Ryuichiro
authors.initials: R
authors.lastname: Sekiya
authors.forename: Hiroko
authors.initials: H
authors.lastname: Mitsui
authors.forename: Shiro
authors.initials: S
authors.lastname: Suzuki
authors.forename: Tomokazu
authors.initials: T
authors.lastname: Umezu
authors.forename: Mika
authors.initials: M
authors.lastname: Mizuno
authors.forename: Eiko
authors.initials: E
authors.lastname: Yamamoto
authors.forename: Kiyosumi
authors.initials: K
authors.lastname: Shibata
authors.forename: Fumitaka
authors.initials: F
authors.lastname: Kikkawa
mesh_terms: D000367:Age Factors; D000701:Analgesics, Opioid / Q000008:administration & dosage*; D005260:Female; D005833:Genital Neoplasms, Female / Q000150:complications* / Q000473:pathology; D006801:Humans; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009362:Neoplasm Metastasis; D010051:Ovarian Neoplasms / Q000150:complications / Q000473:pathology; D010146:Pain / Q000188:drug therapy* / Q000209:etiology; D010388:Pelvis; D012189:Retrospective Studies; D012307:Risk Factors; D013727:Terminal Care; D002583:Uterine Cervical Neoplasms / Q000150:complications / Q000473:pathology; D014625:Vaginal Neoplasms / Q000150:complications / Q000473:pathology; D014846:Vulvar Neoplasms / Q000150:complications / Q000473:pathology
chemical_list: D000701:Analgesics, Opioid