Observational studyBritish journal of anaesthesia2022
Intraoperative opioids are associated with decreased recurrence rates in colon adenocarcinoma: a retrospective observational cohort study.
Observational study in British journal of anaesthesia, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it, 23 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
- General and Regional Anaesthesia in Cancer Surgery: A 20-year Bibliometric Analysis.Turkish journal of anaesthesiology and reanimation · 2026Article
- Evolution of pain management in lung cancer surgery: from opioid-based to personalized analgesia.Anesthesia and pain medicine · 2025Review
- 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
- Morphine-Induced Elevation of Reactive Oxygen Species Attenuates Chemotherapy Efficacy in Diverse Cancer Cell Types.Current molecular medicine · 2025Article
- Impact of Surgical and Anesthetic Procedures after Colorectal Cancer Surgery: A Propensity Score-Matched Cohort Study (The PROCOL Study).Medicina (Kaunas, Lithuania) · 2024Article
- Anesthesia and cancer recurrence: a narrative review.Anesthesia and pain medicine · 2024Review
- Personalized anesthesia and precision medicine: a comprehensive review of genetic factors, artificial intelligence, and patient-specific factors.Frontiers in medicine · 2024Review
- Towards a precision approach to anesthetic/analgesic immunomodulation in cancer.Frontiers in anesthesiology · 2024Article
- Anaesthetic Techniques and Strategies: Do They Influence Oncological Outcomes?Current oncology (Toronto, Ont.) · 2023Review
- Opioids and immune checkpoint inhibitors differentially regulate a common immune network in triple-negative breast cancer.Frontiers in oncology · 2023Article
- Article
Corrections and comments
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Authors and funding
17 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundOpioid-induced immunomodulation may be important in colon adenocarcinoma, where tumour DNA mismatch repair (MMR) can determine the level of immune activation with consequences for therapeutic response and prognosis. We evaluated the relationship between intraoperative opioid exposure, MMR subtype, and oncological outcomes after surgery for colon adenocarcinoma.
methodsIntraoperative opioid use (standardised by calculating morphine milligram equivalents) during stage I-III colon adenocarcinoma resection was reviewed retrospectively. Tumours were classified as DNA mismatch repair deficient (dMMR) or proficient (pMMR) by immunohistochemistry. The primary outcome was local tumour recurrence, distant tumour recurrence, or both (multivariable analysis). The exposures of interest were intraoperative analgesia and tumour subtype. Opioid-related gene expression was analysed using The Cancer Genome Atlas Colon Adenocarcinoma transcriptomic data.
resultsClinical and pathological data were analysed from 1157 subjects (median age, 60 [51-70] yr; 49% female) who underwent curative resection for stage I-III colon adenocarcinoma. Higher intraoperative opioid doses were associated with reduced risk of tumour recurrence (hazard ratio=0.92 per 10 morphine milligram equivalents; 95% confidence interval [95% CI], 0.87-0.98; P=0.007), but not with overall survival. In tumours deficient in DNA MMR, tumour recurrence was less likely (HR=0.38; 95% CI, 0.21-0.68; P=0.001), with higher opioid dose associated with eightfold lower recurrence rates. Gene expression related to opioid signalling was different between dMMR and pMMR tumours.
conclusionsHigher intraoperative opioid dose was associated with a lower risk of tumour recurrence after surgery for stage I-III colon adenocarcinoma, but particularly so in tumours in which DNA MMR was deficient.
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