Postoperative opioid use and survival outcomes in patients with head and neck adenoid cystic carcinoma. A retrospective study.

OBJECTIVES

To evaluate the incidence and risk factors of chronic opioid use following head and neck adenoid cystic carcinoma (HNACC) surgery and explore the association between postoperative opioid use and survival outcomes.

DESIGN

Observational retrospective cohort study.

SETTINGS: Perioperative care of cancer patients at the UT - MD Anderson Cancer Center.

SUBJECTS: Adults (≥18 years) who underwent HNACC surgery with curative intent were included; while those with recurrent or metastatic disease at the time of surgery or who received palliative treatment were excluded.

METHODS

Multivariable logistics and Cox regression analyses were performed to identify predictors of chronic opioid use and explore associations with recurrence-free survival (RFS) and overall survival (OS). Chronic opioid use was defined as an active opioid prescription documented and reconciled by a clinician on postoperative day 90 (POD90).

RESULTS

Among 102 subjects included in the study, 47.1% were taking opioids chronically after surgery. Preoperative opioid use was associated with more than double the odds of chronic postoperative opioid use, whereas older age and ASA class 1-2 were associated with reduced odds. Positive surgical margins, bone graft procedures, and neck dissection were independently associated with poorer prognosis. No statistically significant association between opioid use an RFS and OS was observed.

CONCLUSIONS

These findings suggest that patients with HNACC exhibit several risk factors for chronic opioid use, underscoring the importance of careful opioid prescribing and monitoring in this population.