Intraoperative opioids use for laryngeal squamous cell carcinoma surgery and recurrence: a retrospective study

Study 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. Design: Retrospective study. Setting: Academic hospital. Subjects: Patients with laryngeal primary or recurrent laryngeal squamous cell carcinoma who had surgery. Interventions: Intravenous opioids (remifentanil, fentanyl, sufentanil, and hydromorphone). Measurements: Univariate and multicovariate Cox proportional hazards models were applied to assess the effects of covariates of interest on OS and RFS. Main 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. (C) 2015 Elsevier Inc. All rights reserved.