Owusu-Agyemang Pascal, Hayes-Jordan Andrea, Van Meter Antoinette, Williams Uduak U, Zavala Acsa M, Kapoor Ravish, Popovich Shannon M, Rebello Elizabeth, Feng Lei, Cata Juan P
Department of Anesthesiology and Perioperative Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Anesthesiology and Surgical Oncology Research Group, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Paediatr Anaesth. 2017 Jun;27(6):648-656. doi: 10.1111/pan.13146. Epub 2017 Apr 17.
Several studies in adult patients have suggested an unfavorable association between opioid consumption and cancer progression.
This study investigated the impact of opioid consumption on the survival of children and adolescents undergoing cytoreductive surgery with hyperthermic intraperitoneal chemotherapy.
A retrospective study of patients <19 years who had undergone cytoreductive surgery with hyperthermic intraperitoneal chemotherapy was performed. Univariate and multivariate Cox proportional hazard analyses were used to identify factors associated with recurrence-free survival and overall survival.
Seventy-five patients were identified. Median age was 11.6 years (range, 1.8-18.9), and 43% was female. Median perioperative opioid consumption was 18.9 morphine dose equivalents per kilogram (range, 0.6-339.6). There was no statistically significant association between opioid consumption and recurrence-free survival [hazard ratio, 1.00; 95% confidence interval, (0.99-1.02), P = 0.55] or overall survival [hazard ratio 1.01; 95% confidence interval (0.99-1.03), P = 0.22]. Independent prognostic factors associated with poor survival included incomplete cytoreduction and extra-abdominal disease.
In this retrospective study of children and adolescents who had undergone cytoreductive surgery with hyperthermic intraperitoneal chemotherapy, there was no statistically significant association between opioid consumption and recurrence-free survival or overall survival.
多项针对成年患者的研究表明，阿片类药物的使用与癌症进展之间存在不良关联。
本研究调查了阿片类药物的使用对接受减瘤手术联合热腹腔内化疗的儿童和青少年生存的影响。
对年龄小于19岁且接受减瘤手术联合热腹腔内化疗的患者进行回顾性研究。采用单因素和多因素Cox比例风险分析来确定与无复发生存率和总生存率相关的因素。
共纳入75例患者。中位年龄为11.6岁（范围1.8 - 18.9岁），43%为女性。围手术期阿片类药物的中位使用量为每千克18.9吗啡剂量当量（范围0.6 - 339.6）。阿片类药物使用与无复发生存率[风险比，1.00；95%置信区间，(0.99 - 1.02)，P = 0.55]或总生存率[风险比1.01；95%置信区间(0.99 - 1.03)，P = 0.22]之间无统计学显著关联。与生存不良相关的独立预后因素包括减瘤不完全和腹外疾病。
在这项针对接受减瘤手术联合热腹腔内化疗的儿童和青少年的回顾性研究中，阿片类药物使用与无复发生存率或总生存率之间无统计学显著关联。
