ArticleBritish journal of anaesthesia2021
Intraoperative opioid exposure, tumour genomic alterations, and survival differences in people with lung adenocarcinoma.
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 31 papers, 3 of them syntheses that pooled it.
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Who cites it
31 citing papers in PubMed, 3 syntheses or guidelines pooled it, 55 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
- Systematic review on postoperative opioid use and other outcomes after lobectomy for lung cancer in the U.S.Future oncology (London, England) · 2025Pooled it
- Effect of combined epidural-general anesthesia on long-term survival of patients with colorectal cancer: a meta-analysis of cohort studies.International journal of colorectal disease · 2022Pooled it
- Application Effect of Dexmedetomidine and Dezocine in Patients Undergoing Lung Cancer Surgery under General Anesthesia and Analysis of Their Roles in Recovery Time and Cognitive Function.Computational and mathematical methods in medicine · 2022Trial
- General and Regional Anaesthesia in Cancer Surgery: A 20-year Bibliometric Analysis.Turkish journal of anaesthesiology and reanimation · 2026Article
- Anti-tumour effects of perioperative ketamine in lung cancer: a non-randomised, exploratory biomarker study.British journal of anaesthesia · 2025Article
- Immunomodulatory potential of dexmedetomidine in perioperative pain management for patients with cancer.Cancer pathogenesis and therapy · 2025Review
- Evolution of pain management in lung cancer surgery: from opioid-based to personalized analgesia.Anesthesia and pain medicine · 2025Review
- Review
- Targeting the kappa opioid receptor for analgesia and antitumour effects.British journal of anaesthesia · 2025Article
- κ-opioid receptor: from analgesic target to neuroimmune hub.Frontiers in pharmacology · 2025Review
- Towards a precision approach to anesthetic/analgesic immunomodulation in cancer.Frontiers in anesthesiology · 2024Article
- Personalized anesthesia and precision medicine: a comprehensive review of genetic factors, artificial intelligence, and patient-specific factors.Frontiers in medicine · 2024Review
- Impact of Opioids on Cellular Metabolism: Implications for Metabolic Pathways Involved in Cancer.Pharmaceutics · 2023Review
- Anaesthetic Techniques and Strategies: Do They Influence Oncological Outcomes?Current oncology (Toronto, Ont.) · 2023Review
- Preoperative transversus abdominis plane block decreases intraoperative opiate consumption during minimally invasive cholecystectomy.Surgical endoscopy · 2023Article
- Review
- Perioperative Pain Management and Cancer Outcomes: A Narrative Review.Journal of pain research · 2023Review
- Perioperative lidocaine and dexmedetomidine intravenous infusion reduce the serum levels of NETs and biomarkers of tumor metastasis in lung cancer patients: A prospective, single-center, double-blinded, randomized clinical trial.Frontiers in oncology · 2023Article
- Opioids and immune checkpoint inhibitors differentially regulate a common immune network in triple-negative breast cancer.Frontiers in oncology · 2023Article
Corrections and comments
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Authors and funding
18 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundOpioids have been linked to worse oncologic outcomes in surgical patients. Studies in certain cancer types have identified associations between survival and intra-tumoural opioid receptor gene alterations, but no study has investigated whether the tumour genome interacts with opioid exposure to affect survival. We sought to determine whether intraoperative opioid exposure is associated with recurrence-specific survival and overall survival in early-stage lung adenocarcinoma, and whether selected tumour genomics are associated with this relationship. Associations between ketamine and dexmedetomidine and outcomes were also studied.
methodsSurgical patients (N=740) with pathological stage I-III lung adenocarcinoma and next-generation sequencing data were retrospectively reviewed from a prospectively maintained database.
resultsOn multivariable analysis, ketamine administration was protective for recurrence-specific survival (hazard ratio = 0.44, 95% confidence interval 0.24-0.80; P=0.007), compared with no adjunct. Higher intraoperative oral morphine milligram equivalents were significantly associated with worse overall survival (hazard ratio=1.09/10 morphine milligram equivalents, 95% confidence interval 1.02-1.17; P=0.010). Significant interaction effects were found between morphine milligram equivalents and fraction genome altered and morphine milligram equivalents and CDKN2A, such that higher fraction genome altered or CDKN2A alterations were associated with worse overall survival at higher morphine milligram equivalents (P=0.044 and P=0.052, respectively). In contrast, alterations in the Wnt (P=0.029) and Hippo (P=0.040) oncogenic pathways were associated with improved recurrence-specific survival at higher morphine milligram equivalents, compared with unaltered pathways.
conclusionsIntraoperative opioid exposure is associated with worse overall survival, whereas ketamine exposure is associated with improved recurrence-specific survival in patients with early-stage lung adenocarcinoma. This is the first study to investigate tumour-specific genomic interactions with intraoperative opioid administration to modify survival associations.
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