An investigation of the relationships between postoperative pain trajectories and outcomes after surgery for colorectal cancer

Journal of the Chinese Medical Association : JCMA
Wen-Kuei ChangKuang-Yi Chang

Abstract

Although animal studies have shown that pain can suppress host immunity and promote tumor metastasis, few clinical studies have evaluated the association between acute pain and long-term outcomes after cancer surgery. Patients undergoing colorectal cancer resection at a medical center between November 2010 and December 2014 were collected. Pain intensity was recorded using a numeric rating scale at 12, 24, 36, 48, 72, 96, and 120 hours postoperatively. Group-based modeling of longitudinal pain scores was used to categorize pain trajectories. Recurrence-free survival and overall survival were analyzed using Cox proportional hazards models. A total of 2,401 patients with 13,931 pain score observations were analyzed. The trajectory model identified three groupings of inpatient postsurgical pain, including 70.3% with mild pain dropping to low (group 1), 20.0% with moderate/severe pain dropping to mild (group 2), and 9.7% with moderate pain rebounding to severe (group 3). Univariate models showed that pain trajectories were significantly associated with recurrence-free survival (group 2 vs. 1: hazard ratio, HR = 1.23, 95% confidence interval (CI): 1.02-1.47; group 3 vs. 1: HR = 1.63, 95% CI: 1.30-2.04) and overall survival (group 2 ...Continue Reading

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May 7, 2015·Diseases of the Colon and Rectum·John HoganJohn Calvin Coffey

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Citations

Sep 14, 2019·Journal of the Chinese Medical Association : JCMA·Chih-Hsuan SaoPeng-Hui Wang
Nov 13, 2020·Journal of the Chinese Medical Association : JCMA·Wei-Nung TengKuang-Yi Chang

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