title: Intraoperative opioids use for laryngeal squamous cell carcinoma surgery and recurrence: a retrospective study.
abstract: OBJECTIVE
  To assess whether the use of intraoperative opioids is associated with poor recurrence-free survival (RFS) and overall survival (OS) after lung cancer surgery.
  
  
  METHODS
  Retrospective study.
  
  
  METHODS
  Academic hospital.
  
  
  METHODS
  Patients with laryngeal primary or recurrent laryngeal squamous cell carcinoma who had surgery.
  
  
  METHODS
  Intravenous opioids (remifentanil, fentanyl, sufentanil, and hydromorphone).
  
  
  METHODS
  Univariate and multicovariate Cox proportional hazards models were applied to assess the effects of covariates of interest on OS and RFS.
  
  
  RESULTS
  A total of 195 patients were included. All received opioids intraoperatively. The multivariate analysis demonstrated that age (hazard ratio [HR], 1.03; P = .005), negative margin status (HR, 0.163; P = .001], postoperative chemotherapy (HR, 7.38; P < .001), and concurrent chemotherapy and radiation (HR, 3.11; P < .001) treatment and fentanyl equivalent use (HR, 1.001; P = .02) were all predictor factors for 3- and 5-year RFS. The same variables were predictor factors for OS (age: HR, 1.03 [P = .003]; negative margin status: HR, 0.14 [P = .001]; postoperative chemotherapy: HR, 4 [P < .0001]; and fentanyl equivalent use: HR, 1.001 [P = .02]).
  
  
  CONCLUSIONS
  Our study demonstrates a very weak association between the use of intraoperative opioids and cancer recurrence after laryngeal squamous cell carcinoma surgery.
authors.affiliation: Department of Anaesthesiology and Perioperative Medicine, The University of Texas MD Anderson Cancer Centre, Houston, TX, USA; Anesthesia and Surgical Oncology Research Group. Houston, TX, USA. Electronic address: jcata@mdanderson.org.
authors.forename: Juan P
authors.initials: JP
authors.lastname: Cata
authors.affiliation: Department of Surgical Oncology, The University of Texas MD Anderson Cancer Centre, Houston, TX, USA.
authors.forename: Mark
authors.initials: M
authors.lastname: Zafereo
authors.affiliation: Department of Anaesthesiology and Perioperative Medicine, The University of Texas MD Anderson Cancer Centre, Houston, TX, USA.
authors.forename: John
authors.initials: J
authors.lastname: Villarreal
authors.affiliation: Department of Surgical Oncology, The University of Texas MD Anderson Cancer Centre, Houston, TX, USA.
authors.forename: Bryant D
authors.initials: BD
authors.lastname: Unruh
authors.affiliation: Department of Anaesthesiology and Perioperative Medicine, The University of Texas MD Anderson Cancer Centre, Houston, TX, USA.
authors.forename: Angela
authors.initials: A
authors.lastname: Truong
authors.affiliation: Department of Anaesthesiology and Perioperative Medicine, The University of Texas MD Anderson Cancer Centre, Houston, TX, USA.
authors.forename: Dam-Thuy
authors.initials: DT
authors.lastname: Truong
authors.affiliation: Department of Biostatistics, The University of Texas MD Anderson Cancer Centre, Houston, TX, USA.
authors.forename: Lei
authors.initials: L
authors.lastname: Feng
authors.affiliation: Department of Anaesthesiology and Perioperative Medicine, The University of Texas MD Anderson Cancer Centre, Houston, TX, USA.
authors.forename: Vijaya
authors.initials: V
authors.lastname: Gottumukkala
mesh_terms: D061605:Administration, Intravenous; D000368:Aged; D000701:Analgesics, Opioid / Q000008:administration & dosage* / Q000009:adverse effects; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D006258:Head and Neck Neoplasms / Q000473:pathology / Q000601:surgery*; D006801:Humans; D007430:Intraoperative Care; D007822:Laryngeal Neoplasms / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D000077195:Squamous Cell Carcinoma of Head and Neck; D015996:Survival Rate
chemical_list: D000701:Analgesics, Opioid
keywords: Cancer recurrence; Laryngeal squamous cell carcinoma; Opioids; Surgery; Survival