Opioids and premature biochemical recurrence of prostate cancer: a randomised prospective clinical trial.

摘要: Abstract Background Prostate cancer is one of the most prevalent neoplasms in male patients, and surgery main treatment. Opioids can have immune modulating effects, but their relation to recurrence unclear. We evaluated whether opioids used during prostatectomy affect biochemical recurrence-free survival. Methods randomised 146 patients with prostate scheduled for into opioid-free anaesthesia or opioid-based groups. Baseline characteristics, perioperative data, level prostate-specific antigen every 6 months 2 yr after were recorded. Prostate-specific >0.2 ng ml−1 was considered recurrence. A survival analysis compared time between groups, a Cox regression modelled evaluate which variables Results observed 31 events: 17 group 14 group. Biochemical not statistically different groups (P=0.54). revealed that shorter cases obesity (hazard ratio [HR] 1.63, confidence interval [CI] 0.16–3.10; p=0.03), high D'Amico risk (HR 1.58, CI 0.35–2.81; P=0.012), laparoscopic 1.6, 0.38–2.84; P=0.01), stage 3 tumour pathology 1.60, 0.20–299) N1 status 1.34, 0.28–2.41), positive surgical margins 1.37, 0.50–2.24; P=0.002). The technique did (HR −1.03, CI −2.65–0.49; P=0.18). Conclusions Intraoperative opioid use modify rates intermediate undergoing radical prostatectomy. Clinical trial registration NCT03212456 .