468P - Association between Opioid Use and Survival Time in Patients with Unresectable Pancreatic Cancer: 10 Years of Clinical Experience (468P)

Date 18 November 2017
Event ESMO Asia 2017 Congress
Session Poster lunch
Topics Palliative Care
Pancreatic Cancer
Palliative and Supportive Care
Presenter Tak Kyu Oh
Citation Annals of Oncology (2017) 28 (suppl_10): x144-x148. 10.1093/annonc/mdx673
Authors T.K. Oh
  • Anesthesiology And Pain Medicine, Seoul National University Bundang Hospital, 13264 - Seoungnam/KR



Patients with pancreatic cancer generally experience increasing pain as their disease progresses, making titration of opioids difficult. We performed this study to determine if there is a correlation between prescribed opioid doses and survival time in patients with unresectable pancreatic cancer.


This study is retrospective, observational cohort study in a tertiary care institution (Seoul National University Bundang Hospital). The medical records of patients diagnosed with unresectable pancreatic cancer and treated over a 10-year period were reviewed. Data were collected on the average opioid doses prescribed in the first month after diagnosis (initial dose) and in the final month of life (the final dose). The primary outcome was the relationship between survival time and the initial and/or final prescribed opioid doses. The secondary outcome was the association of increasing opioid dose with probability of death within 180 days of diagnosis. The data were analyzed using Pearson correlation and probit analyses.


Of 1152 patients with unresectable pancreatic cancer screened, 566 were eligible for inclusion in the study. The mean initial morphine equivalent daily dose (MEDD) was 55.94 ± 53.80 mg and the mean final MEDD was 162.82 ± 131.64 mg. The timing of the initial opioid dose in relation to diagnosis had a significant negative correlation with both survival duration (correlation coefficient -0.218, P < 0.01) and probability of death in ≤ 180 days (correlation coefficient -0.210, P < 0.01). There was a significant positive correlation between the final opioid dose prescribed and survival time after starting opioids (correlation coefficient 0.189, P < 0.01) but not with survival time after diagnosis. Increases in MEDD to 1.154 mg per day and 36.948 mg per month were associated with a 50% probability of death in ≤ 180 days.


There was a correlation between patient survival and the initial opioid doses, the rates of increase in these doses, and the final opioid doses prescribed. Further hospice-based prospective studies are necessary to identify an appropriate opioid titration protocol for patients with pancreatic cancer.

Clinical trial identification

Legal entity responsible for the study

Institutional Review Board approval number: B1704-390-103 (Seoul National University Bundang Hospital)




All authors have declared no conflicts of interest.