ArticleCancer2013
Opioid requirement, opioid receptor expression, and clinical outcomes in patients with advanced prostate cancer.
Article in Cancer, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 105 papers, 3 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
105 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Perioperative opioids and survival outcomes in resectable head and neck cancer: A systematic review.Cancer medicine · 2023Pooled it
- A systematic review of the impact of pain on overall survival in patients with cancer.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2017Pooled it
- Regional anesthesia/analgesia and the risk of cancer recurrence and mortality after prostatectomy: a meta-analysis.Pain management · 2015Pooled it
- Comparison of erector spinae plane block and serratus anterior plane block for postoperative analgesia in uniportal thoracoscopic lobectomy: a randomized controlled trial.BMC anesthesiology · 2023Trial
- The influence of brain metastases on the central nervous system effects of methylnaltrexone: a post hoc analysis of 3 randomized, double-blind studies.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2021Trial
- The relationship between the level of μ-opioid receptor (μORs) and postoperative analgesic use in patients undergoing septoplasty: a prospective randomized controlled trial.BMC anesthesiology · 2020Trial
- Comparison of Biochemical Recurrence After Robot-assisted Laparoscopic Radical Prostatectomy with Volatile and Total Intravenous Anesthesia.International journal of medical sciences · 2020Trial
- The effect of anesthetic technique on µ-opioid receptor expression and immune cell infiltration in breast cancer.Journal of anesthesia · 2018Trial
- OPRM1 Methylation Contributes to Opioid Tolerance in Cancer Patients.The journal of pain · 2017Trial
- Treatment with methylnaltrexone is associated with increased survival in patients with advanced cancer.Annals of oncology : official journal of the European Society for Medical Oncology · 2016Trial
- Cancer-related pain: A bidirectional modulator of cancer progression.Clinical and translational medicine · 2026Review
- Receptor Binding, Functional Activity, and Cell Viability Assessment of Novel Marine-Based Hybrid Peptides fromMarine drugs · 2026Article
- The effect of opium consumption on prostate cancer among Iranian patients: A retrospective analytical study.Medicine · 2026Article
- The impact of concomitant medications on treatment outcomes in patients with cancer receiving immune checkpoint inhibitors.Nature reviews. Cancer · 2026Review
- Article
- Exploring the Effects of Opioid-Related Drugs on the Clinical Outcome of Prostate Cancer Patients Via Integrated Bioinformatics Analysis.Molecular biotechnology · 2026Article
- Research Trends and Knowledge Mapping of Opioid-Free Anesthesia: A Global Bibliometric Analysis.Journal of multidisciplinary healthcare · 2025Article
- Controversial Role of Opioids: From Pain Control to Cancer Recurrence in Breast Cancer.Current cancer drug targets · 2025Review
- Anesthetic Approaches and Their Impact on Cancer Recurrence and Metastasis: A Comprehensive Review.Cancers · 2024Review
- The Role of Anesthetic Management in Lung Cancer Recurrence and Metastasis: A Comprehensive Review.Journal of clinical medicine · 2024Review
45 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
10 authors.
Funding
Abstract
backgroundPreclinical studies show that opioids stimulate angiogenesis and tumor progression through the mu opioid receptor (MOR). Although MOR is overexpressed in several human malignancies, the effect of chronic opioid requirement on cancer progression or survival has not been examined in humans.
methodsWe performed a retrospective analysis on 113 patients identified in the Minneapolis VA Tumor Registry (test cohort) and 480 patients from the national VA Central Cancer Registry (validation cohort) who had been diagnosed with stage IV prostate cancer between 1995 and 2010 to examine whether MOR expression or opioid requirement is associated with disease progression and survival. All opioids were converted to oral morphine equivalents for comparison. Laser scanning confocal microscopy was used to analyze MOR immunoreactivity in prostate cancer biopsies. The effects of variables on outcomes were analyzed in univariable and multivariable models.
resultsIn patients with metastatic prostate cancer, MOR expression and opioid requirement were independently associated with inferior progression-free survival (hazard ratio [HR] 1.65, 95% confidence interval [CI] 1.33-2.07, P<.001 and HR 1.08, 95% CI 1.03-1.13, P<.001, respectively) and overall survival (HR 1.55, 95% CI 1.20-1.99, P<.001 and HR 1.05, 95% CI 1.00-1.10, P = .031, respectively). The validation cohort confirmed that increasing opioid requirement was associated with worse overall survival (HR 1.005, 95% CI 1.002-1.008, P = .001).
conclusionHigher MOR expression and greater opioid requirement are associated with shorter progression-free survival and overall survival in patients with metastatic prostate cancer. Nevertheless, clinical practice should not be changed until prospective randomized trials show that opioid use is associated with inferior clinical outcomes, and that abrogation of the peripheral activities of opioids ameliorates this effect.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.