This study aimed to evaluate the oncologic significance of
opioid use during active treatment for advanced
colorectal cancer (CRC). The patients included in this study underwent therapeutic
chemotherapy for metastatic and/or recurrent CRC. The primary outcomes measured were the characteristics of CRC patients who were administered
opioid to maintain compliance with
cancer treatments as well as the impact of
opioid use on
cancer-specific survival. Of the 245 patients, 117 (48%) were administered
opioid during
chemotherapy. No significant associations were detected between
opioid use and clinicopathological factors, with the exception of age (<65 or ≥65 years; P= 0.0281), pathology (differentiated or undifferentiated; P= 0.0007) and response rate to
chemotherapy (P= 0.0056). Patients administered
opioid had significantly poorer
cancer-specific survival compared to patients who did not receive
opioid. The mean
cancer-specific survival periods were 606±57 days (
chemotherapy with
opioid), <636±46 days (
chemotherapy without
opioid), <1140±95 days (multimodal
therapy with
opioid) and <1556±160 days (multimodal
therapy without
opioid). Additionally, oncologic emergencies due to
cancer progression were significantly correlated with
opioid use (P=0.0002), although no statistically significant differences were detected between the
cancer-specific survival period and oncologic emergencies. The use of
opioid to maintain compliance with active
cancer therapy is advised in modern CRC management. However, CRC patients that were administered
opioid may have potential progressive disease, thus clinicians need to be aware of the oncologic emergencies possibly arising during an active CRC
therapy.