ArticleBritish journal of anaesthesia2021
Intraoperative opioids are associated with improved recurrence-free survival in triple-negative breast cancer.
Article in British journal of anaesthesia, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 44 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
The trial behind it
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
44 citing papers in PubMed, 3 syntheses or guidelines pooled it, 68 citations in OpenAlex.
- The organ-specific modulation of malignant processes by opioids: a systematic review of cell culture studies.British journal of cancer · 2025Pooled it
- Perioperative opioids and survival outcomes in resectable head and neck cancer: A systematic review.Cancer medicine · 2023Pooled it
- Pooled it
- Tramadol induced hypoxia signaling and paraptosis-like cell death in breast cancer cells via HIF-1α and ATF4 dependent pathways.Redox report : communications in free radical research · 2026Article
- Relationship between expression of OGFR, P16, P21 and clinicopathological features of colorectal cancer patients.Journal, genetic engineering & biotechnology · 2026Article
- General and Regional Anaesthesia in Cancer Surgery: A 20-year Bibliometric Analysis.Turkish journal of anaesthesiology and reanimation · 2026Article
- Article
- Integrated bioinformatics analysis reveals that OPRK1 inhibits ferroptosis and induces enzalutamide resistance in prostate cancer.European journal of medical research · 2025Article
- Review
- Targeting the kappa opioid receptor for analgesia and antitumour effects.British journal of anaesthesia · 2025Article
- Kappa opioid receptor internalisation-induced p38 nuclear translocation suppresses glioma progression.British journal of anaesthesia · 2025Article
- Controversial Role of Opioids: From Pain Control to Cancer Recurrence in Breast Cancer.Current cancer drug targets · 2025Review
- κ-opioid receptor: from analgesic target to neuroimmune hub.Frontiers in pharmacology · 2025Review
- Relationship between GTP binding protein RAB10, toll-like receptor 4, and nuclear factor kappa-B and prognosis in patients with breast cancer.Scientific reports · 2024Article
- Anesthesia and cancer recurrence: a narrative review.Anesthesia and pain medicine · 2024Review
- Review
- Towards a precision approach to anesthetic/analgesic immunomodulation in cancer.Frontiers in anesthesiology · 2024Article
- Impact of anesthetic factors on prognosis of patients with non-small cell lung cancer after surgery.Journal of thoracic disease · 2023Article
- Anaesthetic Techniques and Strategies: Do They Influence Oncological Outcomes?Current oncology (Toronto, Ont.) · 2023Review
- Mapping the Evidence for Opioid-Mediated Changes in Malignancy and Chemotherapeutic Efficacy: Protocol for a Scoping Review.JMIR research protocols · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
12 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundOpioid-induced immunomodulation may be of particular importance in triple-negative breast cancer (TNBC) where an immune response is associated with improved outcome and response to immunotherapy. We evaluated the association between intraoperative opioids and oncological outcomes and explored patterns of opioid receptor expression in TNBC.
methodsConsecutive patients with stage I-III primary TNBC were identified from a prospectively maintained database. Opioid receptor expression patterns in the tumour microenvironment were analysed using publicly available bulk and single-cell RNA-seq data.
resultsA total of 1143 TNBC cases were retrospectively analysed. In multivariable analysis, higher intraoperative opioid dose was associated with favourable recurrence-free survival, hazard ratio 0.93 (95% confidence interval 0.88-0.99) per 10 oral morphine milligram equivalents increase (P=0.028), but was not significantly associated with overall survival, hazard ratio 0.96 (95% confidence interval 0.89-1.02) per 10 morphine milligram equivalents increase (P=0.2). Bulk RNA-seq analysis of opioid receptors showed that OPRM1 was nearly non-expressed. Compared with normal breast tissue OGFR, OPRK1, and OPRD1 were upregulated, while TLR4 was downregulated. At a single-cell level, OPRM1 and OPRD1 were not detectable; OPRK1 was expressed mainly on tumour cells, whereas OGFR and TLR4 were more highly expressed on immune cells.
conclusionsWe found a protective effect of intraoperative opioids on recurrence-free survival in TNBC. Opioid receptor expression was consistent with a net protective effect of opioid agonism, with protumour receptors either not expressed or downregulated, and antitumour receptors upregulated. In this era of personalised medicine, efforts to differentiate the effects of opioids across breast cancer subtypes (and ultimately individual patients) should continue.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.