Perioperative opioids and survival outcomes in resectable head and neck cancer: A systematic review
Abstract Background Opioids are a mainstay in pain control for oncologic surgery. The objective of this systematic review is to evaluate the associations of perioperative opioid use with overall survival (OS) and disease‐free survival (DFS) in patients with resectable head and neck cancer (HNC). Met...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2023-09-01
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| Series: | Cancer Medicine |
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| Online Access: | https://doi.org/10.1002/cam4.6524 |
| _version_ | 1797361283259957248 |
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| author | Eric V. Mastrolonardo Derek S. Mann Harleen K. Sethi Bo H. Yun Elliott M. Sina Maria Armache Brooke Worster Christopher E. Fundakowski Leila J. Mady |
| author_facet | Eric V. Mastrolonardo Derek S. Mann Harleen K. Sethi Bo H. Yun Elliott M. Sina Maria Armache Brooke Worster Christopher E. Fundakowski Leila J. Mady |
| author_sort | Eric V. Mastrolonardo |
| collection | DOAJ |
| description | Abstract Background Opioids are a mainstay in pain control for oncologic surgery. The objective of this systematic review is to evaluate the associations of perioperative opioid use with overall survival (OS) and disease‐free survival (DFS) in patients with resectable head and neck cancer (HNC). Methods A systematic review of PubMed, SCOPUS, and CINAHL between 2000 and 2022 was conducted following the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guidelines. Studies investigating perioperative opioid use for patients with HNC undergoing surgical resection and its association with OS and DFS were included. Results Three thousand three hundred seventy‐eight studies met initial inclusion criteria, and three studies representing 562 patients (intraoperative opioids, n = 463; postoperative opioids, n = 99) met final exclusion criteria. One study identified that high intraoperative opioid requirement in oral cancer surgery was associated with decreased OS (HR = 1.77, 95% CI 0.995–3.149) but was not an independent predictor of decreased DFS. Another study found that increased intraoperative opioid requirements in treating laryngeal cancer was demonstrated to have a weak but statistically significant inverse relationship with DFS (HR = 1.001, p = 0.02) and OS (HR = 1.001, p = 0.02). The last study identified that patients with chronic opioid after resection of oral cavity cancer had decreased DFS (HR = 2.7, 95% CI 1.1–6.6) compared to those who were not chronically using opioids postoperatively. Conclusion An association may exist between perioperative opioid use and OS and DFS in patients with resectable HNC. Additional investigation is required to further delineate this relationship and promote appropriate stewardship of opioid use with adjunctive nonopioid analgesic regimens. |
| first_indexed | 2024-03-08T15:51:34Z |
| format | Article |
| id | doaj.art-498c31d9aca946389406163da802e4e4 |
| institution | Directory Open Access Journal |
| issn | 2045-7634 |
| language | English |
| last_indexed | 2024-03-08T15:51:34Z |
| publishDate | 2023-09-01 |
| publisher | Wiley |
| record_format | Article |
| series | Cancer Medicine |
| spelling | doaj.art-498c31d9aca946389406163da802e4e42024-01-09T05:21:15ZengWileyCancer Medicine2045-76342023-09-011218188821888810.1002/cam4.6524Perioperative opioids and survival outcomes in resectable head and neck cancer: A systematic reviewEric V. Mastrolonardo0Derek S. Mann1Harleen K. Sethi2Bo H. Yun3Elliott M. Sina4Maria Armache5Brooke Worster6Christopher E. Fundakowski7Leila J. Mady8Department of Otolaryngology – Head and Neck Surgery Thomas Jefferson University Hospital Philadelphia Pennsylvania USADepartment of Otolaryngology – Head and Neck Surgery Thomas Jefferson University Hospital Philadelphia Pennsylvania USADepartment of Otolaryngology – Head and Neck Surgery Philadelphia College of Osteopathic Medicine Philadelphia Pennsylvania USADepartment of Otolaryngology – Head and Neck Surgery Thomas Jefferson University Hospital Philadelphia Pennsylvania USADepartment of Otolaryngology – Head and Neck Surgery Thomas Jefferson University Hospital Philadelphia Pennsylvania USADepartment of Otolaryngology – Head and Neck Surgery The Johns Hopkins School of Medicine Baltimore Maryland USADepartment of Hospice and Palliative Care Thomas Jefferson University Hospital Philadelphia Pennsylvania USADepartment of Otolaryngology – Head and Neck Surgery Thomas Jefferson University Hospital Philadelphia Pennsylvania USADepartment of Otolaryngology – Head and Neck Surgery The Johns Hopkins School of Medicine Baltimore Maryland USAAbstract Background Opioids are a mainstay in pain control for oncologic surgery. The objective of this systematic review is to evaluate the associations of perioperative opioid use with overall survival (OS) and disease‐free survival (DFS) in patients with resectable head and neck cancer (HNC). Methods A systematic review of PubMed, SCOPUS, and CINAHL between 2000 and 2022 was conducted following the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guidelines. Studies investigating perioperative opioid use for patients with HNC undergoing surgical resection and its association with OS and DFS were included. Results Three thousand three hundred seventy‐eight studies met initial inclusion criteria, and three studies representing 562 patients (intraoperative opioids, n = 463; postoperative opioids, n = 99) met final exclusion criteria. One study identified that high intraoperative opioid requirement in oral cancer surgery was associated with decreased OS (HR = 1.77, 95% CI 0.995–3.149) but was not an independent predictor of decreased DFS. Another study found that increased intraoperative opioid requirements in treating laryngeal cancer was demonstrated to have a weak but statistically significant inverse relationship with DFS (HR = 1.001, p = 0.02) and OS (HR = 1.001, p = 0.02). The last study identified that patients with chronic opioid after resection of oral cavity cancer had decreased DFS (HR = 2.7, 95% CI 1.1–6.6) compared to those who were not chronically using opioids postoperatively. Conclusion An association may exist between perioperative opioid use and OS and DFS in patients with resectable HNC. Additional investigation is required to further delineate this relationship and promote appropriate stewardship of opioid use with adjunctive nonopioid analgesic regimens.https://doi.org/10.1002/cam4.6524cancer managementclinical managementhead and neck cancersurvival |
| spellingShingle | Eric V. Mastrolonardo Derek S. Mann Harleen K. Sethi Bo H. Yun Elliott M. Sina Maria Armache Brooke Worster Christopher E. Fundakowski Leila J. Mady Perioperative opioids and survival outcomes in resectable head and neck cancer: A systematic review Cancer Medicine cancer management clinical management head and neck cancer survival |
| title | Perioperative opioids and survival outcomes in resectable head and neck cancer: A systematic review |
| title_full | Perioperative opioids and survival outcomes in resectable head and neck cancer: A systematic review |
| title_fullStr | Perioperative opioids and survival outcomes in resectable head and neck cancer: A systematic review |
| title_full_unstemmed | Perioperative opioids and survival outcomes in resectable head and neck cancer: A systematic review |
| title_short | Perioperative opioids and survival outcomes in resectable head and neck cancer: A systematic review |
| title_sort | perioperative opioids and survival outcomes in resectable head and neck cancer a systematic review |
| topic | cancer management clinical management head and neck cancer survival |
| url | https://doi.org/10.1002/cam4.6524 |
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