1. Chronic Opioid Use Following Surgery for Oral Cavity Cancer.
- Author
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Pang, John, Tringale, Kathryn R, Tapia, Viridiana J, Moss, William J, May, Megan E, Furnish, Timothy, Barnachea, Linda, Brumund, Kevin T, Sacco, Assuntina G, Weisman, Robert A, Nguyen, Quyen T, Harris, Jeffrey P, Coffey, Charles S, and Califano, Joseph A
- Subjects
Humans ,Carcinoma in Situ ,Mouth Neoplasms ,Opioid-Related Disorders ,Chronic Disease ,Postoperative Complications ,Pain ,Postoperative ,Analgesics ,Opioid ,Disease-Free Survival ,Retrospective Studies ,Middle Aged ,Female ,Male ,Kaplan-Meier Estimate ,Cancer ,Prevention ,Dental/Oral and Craniofacial Disease ,Clinical Research ,Patient Safety ,Good Health and Well Being - Abstract
IMPORTANCE: Opioid misuse and overuse has become an epidemic. Chronic opioid use among oral cavity cancer patients after surgery has not been described. OBJECTIVES: To assess the prevalence of chronic opioid use in patients undergoing surgery for oral cavity cancer, and evaluate possible associated clinical factors; and the association between opioid use and survival. DESIGN, SETTING, AND PARTICIPANTS: For this retrospective cohort study of patients undergoing surgery for oral cavity cancer a consecutive sample of 99 patients between January 1, 2011, and September 30, 2016, were identified through the institutional cancer registry from a single academic center. EXPOSURES: Surgery for oral cavity cancer. MAIN OUTCOMES AND MEASURES: Chronic opioid use, defined as more than 90 days from surgery. Factors associated with chronic opioid use were investigated by univariable and multivariable logistic regression. The Kaplan-Meier method and Cox proportional hazards model were used to assess overall survival and disease-free survival. RESULTS: The mean (SD) patient age was 62.6 (14.3) years; 60 patients (60%) were male. Chronic opioid use was observed in 41 patients (41%). On multivariable logistic regression, preoperative opioid use (odds ratio [OR], 5.6; 95% CI, 2.2-14.3), tobacco use (OR, 2.8; 95% CI, 1.0-8.0), and development of persistence, recurrence, or a second primary tumor (OR, 2.8; 95% CI, 1.0-7.4) were associated with chronic opioid use. Among preoperative opioid users, estimated overall survival (hazard ratio [HR], 3.2; 95% CI, 1.4-7.1) was decreased, and chronic opioid use was associated with decreased disease-free survival (HR, 2.7; 95% CI, 1.1-6.6). CONCLUSIONS AND RELEVANCE: In patients undergoing surgery for oral cavity tumors, the prevalence of chronic opioid use was considerable. Preoperative opioid use, tobacco use, and development of persistence, recurrence, or a second primary tumor were associated with chronic opioid use after surgery, and both preoperative and chronic opioid use were associated with decreased survival.
- Published
- 2017