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Negative oncologic impact of poor postoperative pain control in left-sided pancreatic cancer

DC FieldValueLanguage
dc.contributor.author강창무-
dc.contributor.author이우정-
dc.contributor.author정재욱-
dc.contributor.author황호경-
dc.date.accessioned2017-11-02T08:05:25Z-
dc.date.available2017-11-02T08:05:25Z-
dc.date.issued2017-
dc.identifier.issn1007-9327-
dc.identifier.urihttps://ir.ymlib.yonsei.ac.kr/handle/22282913/154063-
dc.description.abstractAIM: To investigate the association between postoperative pain control and oncologic outcomes in resected pancreatic ductal adenocarcinoma (PDAC). METHODS: From January 2009 to December 2014, 221 patients were diagnosed with PDAC and underwent resection with curative intent. Retrospective review of the patients was performed based on electronic medical records system. One patient without records of numerical rating scale (NRS) pain intensity scores was excluded and eight patients who underwent total pancreatectomy were also excluded. NRS scores during 7 postoperative days following resection of PDAC were reviewed along with clinicopathologic characteristics. Patients were stratified into a good pain control group and a poor pain control group according to the difference in average pain intensity between the early (POD 1, 2, 3) and late (POD 5, 7) postoperative periods. Cox-proportional hazards multivariate analysis was performed to determine association between postoperative pain control and oncologic outcomes. RESULTS: A total of 212 patients were dichotomized into good pain control group (n = 162) and poor pain control group (n = 66). Median follow-up period was 17 mo. A negative impact of poor postoperative pain control on overall survival (OS) was observed in the group of patients receiving distal pancreatectomy (DP group; 42.0 mo vs 5.0 mo, P = 0.001). Poor postoperative pain control was also associated with poor disease-free survival (DFS) in the DP group (18.0 mo vs 8.0 mo, P = 0.001). Patients undergoing pancreaticoduodenectomy or pylorus-preserving pancreaticoduodenectomy (PD group) did not show associations between postoperative pain control and oncologic outcomes. Poor patients' perceived pain control was revealed as an independent risk factor of both DFS (HR = 4.157; 95%CI: 1.938-8.915; P < 0.001) and OS (HR = 4.741; 95%CI: 2.214-10.153; P < 0.001) in resected left-sided pancreatic cancer. CONCLUSION: Adequate postoperative pain relief during the early postoperative period has important clinical implications for oncologic outcomes after resection of left-sided pancreatic cancer.-
dc.description.statementOfResponsibilityopen-
dc.languageEnglish-
dc.publisherBaishideng Publishing Group-
dc.relation.isPartOfWORLD JOURNAL OF GASTROENTEROLOGY-
dc.rightsCC BY-NC-ND 2.0 KR-
dc.rights.urihttps://creativecommons.org/licenses/by-nc-nd/2.0/kr/-
dc.subject.MESHAged-
dc.subject.MESHCarcinoma, Pancreatic Ductal/complications*-
dc.subject.MESHCarcinoma, Pancreatic Ductal/surgery*-
dc.subject.MESHElectronic Health Records-
dc.subject.MESHFemale-
dc.subject.MESHHumans-
dc.subject.MESHImmunosuppression/adverse effects-
dc.subject.MESHMale-
dc.subject.MESHMiddle Aged-
dc.subject.MESHPain Management-
dc.subject.MESHPain, Postoperative/physiopathology*-
dc.subject.MESHPancreatectomy-
dc.subject.MESHPancreatic Neoplasms/complications*-
dc.subject.MESHPancreatic Neoplasms/surgery*-
dc.subject.MESHPrognosis-
dc.subject.MESHProportional Hazards Models-
dc.subject.MESHRetrospective Studies-
dc.subject.MESHRisk Factors-
dc.subject.MESHSeverity of Illness Index-
dc.subject.MESHTreatment Outcome-
dc.titleNegative oncologic impact of poor postoperative pain control in left-sided pancreatic cancer-
dc.typeArticle-
dc.publisher.locationUnited States-
dc.contributor.collegeCollege of Medicine-
dc.contributor.departmentDept. of Surgery-
dc.contributor.googleauthorEun-Ki Min-
dc.contributor.googleauthorJae Uk Chong-
dc.contributor.googleauthorHo Kyoung Hwang-
dc.contributor.googleauthorSang Joon Pae-
dc.contributor.googleauthorChang Moo Kang-
dc.contributor.googleauthorWoo Jung Lee-
dc.identifier.doi10.3748/wjg.v23.i4.676-
dc.contributor.localIdA02993-
dc.contributor.localIdA03710-
dc.contributor.localIdA04497-
dc.contributor.localIdA00088-
dc.relation.journalcodeJ02795-
dc.identifier.eissn2219-2840-
dc.identifier.pmid28216975-
dc.subject.keywordPancreatectomy-
dc.subject.keywordPancreatic cancer-
dc.subject.keywordPostoperative pain-
dc.subject.keywordRecurrence-
dc.subject.keywordSurvival-
dc.contributor.alternativeNameKang, Chang Moo-
dc.contributor.alternativeNameLee, Woo Jung-
dc.contributor.alternativeNameChong, Jae Uk-
dc.contributor.alternativeNameHwang, Ho Kyoung-
dc.contributor.affiliatedAuthorLee, Woo Jung-
dc.contributor.affiliatedAuthorChong, Jae Uk-
dc.contributor.affiliatedAuthorHwang, Ho Kyoung-
dc.contributor.affiliatedAuthorKang, Chang Moo-
dc.citation.titleWorld Journal of Gastroenterology-
dc.citation.volume23-
dc.citation.number4-
dc.citation.startPage676-
dc.citation.endPage686-
dc.identifier.bibliographicCitationWORLD JOURNAL OF GASTROENTEROLOGY, Vol.23(4) : 676-686, 2017-
dc.date.modified2017-11-01-
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers

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