Impact of Celiac Plexus Neurolysis on Survival in Patients with Unresectable Pancreatic Cancer: A Retrospective, Propensity Score Matching Analysis
Pain caused by pancreatic cancer (PC) is difficult to control. Celiac plexus neurolysis (CPN) can effectively control the pain and reduce the use of opioids. However, the effect of CPN on survival for patients with unresectable PC remains controversial. To determine if CPN is associated with surviva...
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| Veröffentlicht in: | Pain physician 2017-03, Vol.20 (3), p.E357-E365 |
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| description | Pain caused by pancreatic cancer (PC) is difficult to control. Celiac plexus neurolysis (CPN) can effectively control the pain and reduce the use of opioids. However, the effect of CPN on survival for patients with unresectable PC remains controversial.
To determine if CPN is associated with survival benefits for these patients.
Retrospective, observational cohort study.
National Cancer Center in Korea.
The CPN group included patients who were diagnosed with unresectable PC and underwent fluoroscopically guided bilateral CPN (10 mL dehydrated alcohol each side) once between January 1, 2006, and December 31, 2013. Patients with PC who did not undergo CPN were in the control group; for the final control group, 1:1 propensity score (PS) matching was conducted with the CPN group. The main outcome was median survival (PC diagnosis to death) after PS matching, assessed using Kaplan-Meier curves.
For the primary overall survival analysis, the CPN and control groups included 110 and 258 patients, respectively. The median survival period was not significantly different between the CPN and control groups (278 vs. 203 days, P = 0.246), even after PS matching (278 vs. 180 days, P = 0.127), or based on time to CPN from diagnosis (≤ 6 vs. > 6 months; 255 vs. 310 days, P = 0.147).
Retrospective design, small sample size, and inconsistent timing of CPN after the diagnosis date.
CPN did not affect survival for patients with unresectable PC. Considering the limitations of the retrospective design, a well-designed prospective design study should be conducted.Key words: Celiac plexus, pancreatic neoplasms, survival, neurolysis, pain, propensity score matching, opioids, cancer. |
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To determine if CPN is associated with survival benefits for these patients.
Retrospective, observational cohort study.
National Cancer Center in Korea.
The CPN group included patients who were diagnosed with unresectable PC and underwent fluoroscopically guided bilateral CPN (10 mL dehydrated alcohol each side) once between January 1, 2006, and December 31, 2013. Patients with PC who did not undergo CPN were in the control group; for the final control group, 1:1 propensity score (PS) matching was conducted with the CPN group. The main outcome was median survival (PC diagnosis to death) after PS matching, assessed using Kaplan-Meier curves.
For the primary overall survival analysis, the CPN and control groups included 110 and 258 patients, respectively. The median survival period was not significantly different between the CPN and control groups (278 vs. 203 days, P = 0.246), even after PS matching (278 vs. 180 days, P = 0.127), or based on time to CPN from diagnosis (≤ 6 vs. > 6 months; 255 vs. 310 days, P = 0.147).
Retrospective design, small sample size, and inconsistent timing of CPN after the diagnosis date.
CPN did not affect survival for patients with unresectable PC. Considering the limitations of the retrospective design, a well-designed prospective design study should be conducted.Key words: Celiac plexus, pancreatic neoplasms, survival, neurolysis, pain, propensity score matching, opioids, cancer.</description><identifier>ISSN: 1533-3159</identifier><identifier>EISSN: 2150-1149</identifier><identifier>PMID: 28339435</identifier><language>eng</language><publisher>United States: American Society of Interventional Pain Physician</publisher><subject>Aged ; Autonomic Nerve Block - methods ; Celiac Plexus - physiopathology ; Female ; Humans ; Male ; Middle Aged ; Pain - physiopathology ; Pain Management - methods ; Pancreatic cancer ; Pancreatic Neoplasms - physiopathology ; Propensity Score ; Republic of Korea ; Retrospective Studies ; Survival analysis</subject><ispartof>Pain physician, 2017-03, Vol.20 (3), p.E357-E365</ispartof><rights>2017. This work is published under https://creativecommons.org/licenses/by-nc/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28339435$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Oh, Tak Kyu</creatorcontrib><creatorcontrib>Lee, Woo Jin</creatorcontrib><creatorcontrib>Woo, Sang Myung</creatorcontrib><creatorcontrib>Kim, Nam Woo</creatorcontrib><creatorcontrib>Yim, Jiyeon</creatorcontrib><creatorcontrib>Kim, Dae Hyun</creatorcontrib><title>Impact of Celiac Plexus Neurolysis on Survival in Patients with Unresectable Pancreatic Cancer: A Retrospective, Propensity Score Matching Analysis</title><title>Pain physician</title><addtitle>Pain Physician</addtitle><description>Pain caused by pancreatic cancer (PC) is difficult to control. Celiac plexus neurolysis (CPN) can effectively control the pain and reduce the use of opioids. However, the effect of CPN on survival for patients with unresectable PC remains controversial.
To determine if CPN is associated with survival benefits for these patients.
Retrospective, observational cohort study.
National Cancer Center in Korea.
The CPN group included patients who were diagnosed with unresectable PC and underwent fluoroscopically guided bilateral CPN (10 mL dehydrated alcohol each side) once between January 1, 2006, and December 31, 2013. Patients with PC who did not undergo CPN were in the control group; for the final control group, 1:1 propensity score (PS) matching was conducted with the CPN group. The main outcome was median survival (PC diagnosis to death) after PS matching, assessed using Kaplan-Meier curves.
For the primary overall survival analysis, the CPN and control groups included 110 and 258 patients, respectively. The median survival period was not significantly different between the CPN and control groups (278 vs. 203 days, P = 0.246), even after PS matching (278 vs. 180 days, P = 0.127), or based on time to CPN from diagnosis (≤ 6 vs. > 6 months; 255 vs. 310 days, P = 0.147).
Retrospective design, small sample size, and inconsistent timing of CPN after the diagnosis date.
CPN did not affect survival for patients with unresectable PC. Considering the limitations of the retrospective design, a well-designed prospective design study should be conducted.Key words: Celiac plexus, pancreatic neoplasms, survival, neurolysis, pain, propensity score matching, opioids, cancer.</description><subject>Aged</subject><subject>Autonomic Nerve Block - methods</subject><subject>Celiac Plexus - physiopathology</subject><subject>Female</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Pain - physiopathology</subject><subject>Pain Management - methods</subject><subject>Pancreatic cancer</subject><subject>Pancreatic Neoplasms - physiopathology</subject><subject>Propensity Score</subject><subject>Republic of Korea</subject><subject>Retrospective Studies</subject><subject>Survival analysis</subject><issn>1533-3159</issn><issn>2150-1149</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNpd0MFO3DAQBuAItSoL9BXQSL300Ei2J_E63FYraJEorAqco4l3Foyydmo7W_Y5-sJELVw4zUj_p5nRHBQzJWtRSlk1H4qZrBFLlHVzWByl9CQE6qbBT8WhMohNhfWs-Hu5HchmCBtYcu_Iwqrn5zHBNY8x9PvkEgQPt2PcuR314DysKDv2OcEflx_h3kdObDN1PU-Rt5Gn3MJyajmewQJ-cY4hDZNxO_4GqxgG9snlPdzaEBl-UraPzj_AwtO_hSfFxw31iT-_1uPi_uL8bvmjvLr5frlcXJWDwiaX1AlVoe4sKjZGz7WuSGCnyChCadcoqJqT5bVquk1XkyVdCaG0YBbabOZ4XHz9P3eI4ffIKbdblyz3PXkOY2qlMVJpI7Ge6Jd39CmMcbo3tUrXWoi5qcWkTl_V2G153Q7RbSnu27d34wtU1H46</recordid><startdate>20170301</startdate><enddate>20170301</enddate><creator>Oh, Tak Kyu</creator><creator>Lee, Woo Jin</creator><creator>Woo, Sang Myung</creator><creator>Kim, Nam Woo</creator><creator>Yim, Jiyeon</creator><creator>Kim, Dae Hyun</creator><general>American Society of Interventional Pain Physician</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>NAPCQ</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20170301</creationdate><title>Impact of Celiac Plexus Neurolysis on Survival in Patients with Unresectable Pancreatic Cancer: A Retrospective, Propensity Score Matching Analysis</title><author>Oh, Tak Kyu ; Lee, Woo Jin ; Woo, Sang Myung ; Kim, Nam Woo ; Yim, Jiyeon ; Kim, Dae Hyun</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-p239t-ab02436bc32e8867664a03b2a82a31cd30a47aced29bfb5aca6400260ee068f73</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Aged</topic><topic>Autonomic Nerve Block - methods</topic><topic>Celiac Plexus - physiopathology</topic><topic>Female</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Pain - physiopathology</topic><topic>Pain Management - methods</topic><topic>Pancreatic cancer</topic><topic>Pancreatic Neoplasms - physiopathology</topic><topic>Propensity Score</topic><topic>Republic of Korea</topic><topic>Retrospective Studies</topic><topic>Survival analysis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Oh, Tak Kyu</creatorcontrib><creatorcontrib>Lee, Woo Jin</creatorcontrib><creatorcontrib>Woo, Sang Myung</creatorcontrib><creatorcontrib>Kim, Nam Woo</creatorcontrib><creatorcontrib>Yim, Jiyeon</creatorcontrib><creatorcontrib>Kim, Dae Hyun</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Nursing & Allied Health Premium</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Pain physician</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Oh, Tak Kyu</au><au>Lee, Woo Jin</au><au>Woo, Sang Myung</au><au>Kim, Nam Woo</au><au>Yim, Jiyeon</au><au>Kim, Dae Hyun</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Impact of Celiac Plexus Neurolysis on Survival in Patients with Unresectable Pancreatic Cancer: A Retrospective, Propensity Score Matching Analysis</atitle><jtitle>Pain physician</jtitle><addtitle>Pain Physician</addtitle><date>2017-03-01</date><risdate>2017</risdate><volume>20</volume><issue>3</issue><spage>E357</spage><epage>E365</epage><pages>E357-E365</pages><issn>1533-3159</issn><eissn>2150-1149</eissn><abstract>Pain caused by pancreatic cancer (PC) is difficult to control. Celiac plexus neurolysis (CPN) can effectively control the pain and reduce the use of opioids. However, the effect of CPN on survival for patients with unresectable PC remains controversial.
To determine if CPN is associated with survival benefits for these patients.
Retrospective, observational cohort study.
National Cancer Center in Korea.
The CPN group included patients who were diagnosed with unresectable PC and underwent fluoroscopically guided bilateral CPN (10 mL dehydrated alcohol each side) once between January 1, 2006, and December 31, 2013. Patients with PC who did not undergo CPN were in the control group; for the final control group, 1:1 propensity score (PS) matching was conducted with the CPN group. The main outcome was median survival (PC diagnosis to death) after PS matching, assessed using Kaplan-Meier curves.
For the primary overall survival analysis, the CPN and control groups included 110 and 258 patients, respectively. The median survival period was not significantly different between the CPN and control groups (278 vs. 203 days, P = 0.246), even after PS matching (278 vs. 180 days, P = 0.127), or based on time to CPN from diagnosis (≤ 6 vs. > 6 months; 255 vs. 310 days, P = 0.147).
Retrospective design, small sample size, and inconsistent timing of CPN after the diagnosis date.
CPN did not affect survival for patients with unresectable PC. Considering the limitations of the retrospective design, a well-designed prospective design study should be conducted.Key words: Celiac plexus, pancreatic neoplasms, survival, neurolysis, pain, propensity score matching, opioids, cancer.</abstract><cop>United States</cop><pub>American Society of Interventional Pain Physician</pub><pmid>28339435</pmid><oa>free_for_read</oa></addata></record> |
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| subjects | Aged Autonomic Nerve Block - methods Celiac Plexus - physiopathology Female Humans Male Middle Aged Pain - physiopathology Pain Management - methods Pancreatic cancer Pancreatic Neoplasms - physiopathology Propensity Score Republic of Korea Retrospective Studies Survival analysis |
| title | Impact of Celiac Plexus Neurolysis on Survival in Patients with Unresectable Pancreatic Cancer: A Retrospective, Propensity Score Matching Analysis |
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