J Cancer 2022; 13(11):3189-3198. doi:10.7150/jca.74674 This issue Cite

Research Paper

The Effect of Intraoperative Fentanyl Consumption on Prognosis of Colorectal Liver Metastasis treated by Simultaneous Resection: A Propensity Score Matching Analysis

Yizhou Zhang1*, Qichen Chen1*, Xiao Chen1, Mingzhu Zhang2, Peng Li2, Zhen Huang1, Hong Zhao1✉, Hongliang Wu2✉

1. Department of Hepatobiliary Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 100021, Beijing, China.
2. Department of Anesthesiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 100021, Beijing, China.
*Equal contribution

Citation:
Zhang Y, Chen Q, Chen X, Zhang M, Li P, Huang Z, Zhao H, Wu H. The Effect of Intraoperative Fentanyl Consumption on Prognosis of Colorectal Liver Metastasis treated by Simultaneous Resection: A Propensity Score Matching Analysis. J Cancer 2022; 13(11):3189-3198. doi:10.7150/jca.74674. https://www.jcancer.org/v13p3189.htm
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Abstract

Graphic abstract

Background: No previous studies have reported the effect of intraoperative opioid consumption in colorectal liver metastasis (CRLM).

Methods: Medical records of patients who received simultaneous resection of CRLM were retrospectively reviewed. Patients with epidural anesthesia, intraoperative morphine, or intraoperative oxycodone were excluded. Patients were separated into high- and low-dose groups by median intraoperative equianalgesic fentanyl dose. Short-term outcomes, progression-free surcical (PFS) and overall survival (OS) were compared between groups before and after 1:1 propensity score matching (PSM). Univariable and multivariable Cox regression analysis were performed to identify independent predictors of survival.

Results: The final study population included 343 patients. Patients were separated into the low dose group (n=172) and the high dose group (n=171) by median intraoperative equianalgesic fentanyl dose (8.33 μg/kg). After PSM, 55 patients in the low dose group were matched to 55 patients in the high dose group and the baseline characteristics of the two groups were balanced. The two groups had no statistically significance difference in severity and categories of postoperative complications before and after PSM. Before PSM, the two groups had similar PFS (median 10.2 vs. 12.4 months, P=0.54) and OS (median 59.0 vs. 58.3 months, P=0.76). Univariate and multivariate Cox regression analyses revealed no statistically significant association between intraoperative equianalgesic fentanyl and PFS (multivariate HR=0.852, 95% CI 0.655-1.11, P=0.235) and OS (multivariate HR=1, 95% CI 0.68-1.49, P = 0.981). After PSM, the two groups also had similar PFS (median 9.2 vs. 10.7 months, P=0.98) and OS (median 51.0 vs. 46.0 months, P=0.39). Univariate and multivariate Cox regression analyses revealed no statistically significant association between intraoperative equianalgesic fentanyl and PFS (multivariate HR=1.05, 95% CI 0.632-1.73, P=0.861) and OS (multivariate HR=1.74, 95% CI 0.892-3.38, P = 0.105).

Conclusion: Intraoperative opioids consumption was not correlated with outcomes of CRLM patients treated with simultaneous resection.

Keywords: Colorectal liver metastasis, fentanyl, opioids, prognosis, recurrence


Citation styles

APA
Zhang, Y., Chen, Q., Chen, X., Zhang, M., Li, P., Huang, Z., Zhao, H., Wu, H. (2022). The Effect of Intraoperative Fentanyl Consumption on Prognosis of Colorectal Liver Metastasis treated by Simultaneous Resection: A Propensity Score Matching Analysis. Journal of Cancer, 13(11), 3189-3198. https://doi.org/10.7150/jca.74674.

ACS
Zhang, Y.; Chen, Q.; Chen, X.; Zhang, M.; Li, P.; Huang, Z.; Zhao, H.; Wu, H. The Effect of Intraoperative Fentanyl Consumption on Prognosis of Colorectal Liver Metastasis treated by Simultaneous Resection: A Propensity Score Matching Analysis. J. Cancer 2022, 13 (11), 3189-3198. DOI: 10.7150/jca.74674.

NLM
Zhang Y, Chen Q, Chen X, Zhang M, Li P, Huang Z, Zhao H, Wu H. The Effect of Intraoperative Fentanyl Consumption on Prognosis of Colorectal Liver Metastasis treated by Simultaneous Resection: A Propensity Score Matching Analysis. J Cancer 2022; 13(11):3189-3198. doi:10.7150/jca.74674. https://www.jcancer.org/v13p3189.htm

CSE
Zhang Y, Chen Q, Chen X, Zhang M, Li P, Huang Z, Zhao H, Wu H. 2022. The Effect of Intraoperative Fentanyl Consumption on Prognosis of Colorectal Liver Metastasis treated by Simultaneous Resection: A Propensity Score Matching Analysis. J Cancer. 13(11):3189-3198.

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