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J. Clin. Med. 2018, 7(2), 33; doi:10.3390/jcm7020033

Long-Term Oncologic Outcomes, Opioid Use, and Complications after Esophageal Cancer Surgery

Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam 13620, Korea
Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seongnam 13620, Korea
Author to whom correspondence should be addressed.
Received: 23 December 2017 / Revised: 12 February 2018 / Accepted: 14 February 2018 / Published: 19 February 2018
(This article belongs to the Special Issue Management of Postoperative Pain)
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Effective and adequate opioid use and prevention of postoperative complications are important for enhanced recovery after surgery. We examined the effects of postoperative opioid use and postoperative complications on overall survival and recurrence-free survival after esophageal cancer surgery. This retrospective cohort study analyzed the records of patients diagnosed with esophageal cancer who underwent the Ivor Lewis operation between January 2005 and December 2011. We collected data on total opioid use for 8 days postoperatively, as well as information on postoperative complications (Clavien-Dindo classification). One hundred and twenty-one patients were included in the final analysis. Total opioid use was not significantly associated with overall survival (p = 0.520) and recurrence-free survival (p = 0.818). In contrast, the hazard ratio of postoperative overall survival was significantly higher with respect to Clavien-Dindo classification 1–2 (hazard ratio: 2.009, p = 0.046), 3a–3b (hazard ratio: 5.759, p < 0.001), and 4a–5 (hazard ratio: 3.982, p = 0.020) complications compared to no complications. Additionally, the hazard ratio of the recurrence-free survival was significantly higher in class 1–2 complications (hazard ratio: 2.336, p = 0.028) compared to none. Our study demonstrates that postoperative opioid use is not associated with survival and recurrence-free survival after esophageal cancer surgery, while postoperative complications may increase the hazard ratio for survival and recurrence-free survival. View Full-Text
Keywords: esophageal neoplasms; esophagus; anesthesia; analgesia esophageal neoplasms; esophagus; anesthesia; analgesia

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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

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MDPI and ACS Style

Oh, T.K.; Kim, K.; Jheon, S.H.; Do, S.-H.; Hwang, J.-W.; Jeon, Y.-T.; Kim, K.; Song, I.-A. Long-Term Oncologic Outcomes, Opioid Use, and Complications after Esophageal Cancer Surgery. J. Clin. Med. 2018, 7, 33.

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