Do Intraoperative Analgesics Influence Breast Cancer Recurrence After Mastectomy? A Retrospective Analysis

Whether intraoperative analgesics have an impact on postoperative cancer recurrence is unknown. Some investigations suggest that the opioids could favor relapse and that regional analgesia and nonsteroidal antiinflammatory drugs could improve cancer prognosis. We retrospectively reviewed our series...

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Bibliographic Details
Published in:	Anesthesia and analgesia Vol. 110; no. 6; pp. 1630 - 1635
Main Authors:	Forget, Patrice, Vandenhende, Julie, Berliere, Martine, Machiels, Jean-Pascal, Nussbaum, Benoît, Legrand, Catherine, De Kock, Marc
Format:	Journal Article
Language:	English
Published:	Hagerstown, MD International Anesthesia Research Society 01-06-2010 Lippincott Williams & Wilkins
Subjects:	Adult Aged Analgesics - therapeutic use Analgesics, Opioid - adverse effects Analgesics, Opioid - therapeutic use Analysis of Variance Anesthesia Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Anti-Inflammatory Agents, Non-Steroidal - adverse effects Anti-Inflammatory Agents, Non-Steroidal - therapeutic use Biological and medical sciences Breast Neoplasms - epidemiology Breast Neoplasms - pathology Breast Neoplasms - surgery Data Collection Disease-Free Survival Endpoint Determination Female Humans Intraoperative Care Kaplan-Meier Estimate Ketorolac - therapeutic use Lymph Nodes - pathology Lymphatic Metastasis - pathology Mastectomy Medical sciences Middle Aged Neoplasm Metastasis Neoplasm Recurrence, Local Pain, Postoperative - drug therapy Regression Analysis Retrospective Studies Mammary gland diseases Breast disease Analgesic Anesthesia Intraoperative Breast cancer Malignant tumor Cancer
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Summary:	Whether intraoperative analgesics have an impact on postoperative cancer recurrence is unknown. Some investigations suggest that the opioids could favor relapse and that regional analgesia and nonsteroidal antiinflammatory drugs could improve cancer prognosis. We retrospectively reviewed our series of breast cancer surgery patients. This retrospective study included 327 consecutive women who underwent mastectomy with axillary dissection for breast cancer. The main objective was to compare the incidence of cancer recurrence among patients who received different analgesics during surgery. Perioperative characteristics, cancer prognostic factors, and the length of surgery were comparable regardless of the analgesics administered. Univariate and multivariate analyses showed a lower cancer recurrence rate when ketorolac was given before surgery (P = 0.019). Other analgesics (sufentanil, ketamine, and clonidine) were not associated with a significant reduction in cancer recurrence rates in our series. This retrospective analysis suggests that intraoperative administration of ketorolac decreases the risk of breast cancer relapse compared with other analgesícs.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0003-2999 1526-7598
DOI:	10.1213/ANE.0b013e3181d2ad07