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- Title
Chronic Opioid Use Following Surgery for Oral Cavity Cancer.
- Authors
John Pang; 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.; Califano III, Joseph A.; Pang, John; Califano, Joseph A 3rd
- Abstract
<bold>Importance: </bold>Opioid misuse and overuse has become an epidemic. Chronic opioid use among oral cavity cancer patients after surgery has not been described.<bold>Objectives: </bold>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.<bold>Design, Setting, and Participants: </bold>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.<bold>Exposures: </bold>Surgery for oral cavity cancer.<bold>Main Outcomes and Measures: </bold>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.<bold>Results: </bold>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).<bold>Conclusions and Relevance: </bold>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.
- Subjects
POSTOPERATIVE pain prevention; ANALGESICS; CHRONIC diseases; MOUTH tumors; NARCOTICS; PROGNOSIS; SUBSTANCE abuse; SURGICAL complications; RETROSPECTIVE studies; CARCINOMA in situ; KAPLAN-Meier estimator
- Publication
JAMA Otolaryngology-Head & Neck Surgery, 2017, Vol 143, Issue 12, p1187
- ISSN
2168-6181
- Publication type
journal article
- DOI
10.1001/jamaoto.2017.0582