Assessing the survival impact of perioperative opioid consumption in children and adolescents undergoing cytoreductive surgery with hyperthermic intraperitoneal chemotherapy

Abstract

Background: Several studies in adult patients have suggested an unfavorable association between opioid consumption and cancer progression.

Aims: This study investigated the impact of opioid consumption on the survival of children and adolescents undergoing cytoreductive surgery with hyperthermic intraperitoneal chemotherapy.

Methods: 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.

Results: 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.

Conclusion: 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.

Keywords: adolescent; child; complications; oncology; opioids; outcomes.