Morais MV, Lopes RA, Oliveira Júnior JO. Cordotomy for pain control and opioid reduction in cancer patients: A cancer center 11-year experience.
EUROPEAN JOURNAL OF SURGICAL ONCOLOGY 2024;
50:108571. [PMID:
39121636 DOI:
10.1016/j.ejso.2024.108571]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2024] [Revised: 06/30/2024] [Accepted: 07/29/2024] [Indexed: 08/12/2024]
Abstract
BACKGROUND
Percutaneous lateral cervical cordotomy (PLCC) is a treatment option for predominantly nociceptive pain of oncological origin that is refractory to conservative methods, with unilateral distribution, particularly in the lower trunk or lower limbs of patients with a life expectancy of less than one year.
OBJECTIVE
The aim of this study was to assess the analgesic efficacy and opioid utilization alteration in patients undergoing PLCC.
METHODS
We retrospectively collected data from patients undergoing PLCC between 2011 and 2021 at the AC Camargo Cancer Center in São Paulo, Brazil.
RESULTS
Sixty-three patients and their respective surgical outcomes were analyzed. The mean preoperative pain intensity, as assessed by the mean numerical rating scale (NRS), was 8.4 (range: 4-10), while postoperatively, it decreased to 0.78 (range: 0-8). Lower postoperative NRS scores were observed for pain in the lower limbs and abdomen compared to the lower thorax. The mean preoperative oral morphine equivalent (OME) consumption was 231.0 mg (range: 30.0-1015.2). At 30 days postoperative, the mean consumption of OME was 120.2 mg (range: 0.0-705.0). Twelve months after surgery, the average consumption of OME was 98.3 mg (range: 0.0-396.0).
CONCLUSION
PLCC is a valuable therapeutic intervention for patients experiencing cancer pain that is unresponsive to conservative treatments. The anticipated analgesic outcomes are generally favorable, particularly in cases where the pain is localized unilaterally in the abdomen or lower body segments.
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