Older patients with advanced pancreatic cancer had better survival if they were prescribed opioids within a year of their cancer diagnosis, according to research published in JCO Oncology Practice.
The study included 5770 patients, aged 65 years and older, who were diagnosed with stage III/IV pancreatic adenocarcinoma between 2007 and 2015. In this cohort, 29.1% of patients were prescribed opioids for at least 60 days within a year after their cancer diagnosis.
Patients given opioid prescriptions had a lower mean age, were more likely to be women, and were more likely to live in nonmetropolitan areas and on the west coast of the United States (P <.05).
Opioid prescriptions were more commonly given to patients who had abdominal pain within 1 month of diagnosis (P =.05), underwent celiac plexus neurolysis (CPN; P <.0001), or were referred to palliative care (P =.006).
Patients with opioid prescriptions were more likely to undergo chemotherapy and radiation (P <.0001), but there was no difference in surgical interventions between the opioid and non-opioid groups (P =.34).
The median survival was significantly longer in patients who received opioid prescriptions than in those who did not — 6.0 months and 4.0 months, respectively (P <.0001). After adjustment for confounders such as treatment type and weighted propensity score, opioid prescriptions remained associated with improved survival (hazard ratio, 0.80; 95% CI, 0.75-0.86).
The association between opioids and improved survival was noted for hydrocodone, hydromorphone, oxycodone, and tramadol (P <.01), but not for other opioids.
“Our finding that opioid prescriptions are associated with increased survival in elderly patients with advanced disease suggests that symptom mitigation should be emphasized in clinical treatment of pancreatic cancer,” the researchers concluded. “Future studies should continue to investigate the interplay between pain control, palliative care referral, and survival in pancreatic cancer.”
Disclosures: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures.
Zylberberg HM, Woodrell C, Rustgi SD, et al. Opioid prescription is associated with increased survival in older adult patients with pancreatic cancer in the United States: A propensity score analysis. JCO Oncol Pract. Published online January 06, 2022. doi:10.1200/OP.21.00488