Negative oncologic impact of poor postoperative pain control in left-sided pancreatic cancer

Table 3 Univariate analysis of factors affecting disease-free survival and overall survival after distal pancreatectomy

	n	DFS		OS
		Median survival (mo)	P value1	Median survival (mo)	P value1
Age
< 65	30	15	0.216	42	0.150
≥ 65	36	11		23
Sex
Female	29	11	0.136	27	0.829
Male	37	18		33
BMI (kg/m2)
< 25	52	11	0.209	30	0.384
≥ 25	14			27
Diabetes
No	46	13	0.674	27	0.654
Yes	20	15
ASA
1/2	49	13	0.569	30	0.903
3/4	16	15
Surgical approach
Open	42	14	0.971	30	0.645
MIS	24	11		41
Spleen preservation
Yes	9	15	0.931	27	0.619
No	57	13		33
Operation time (min)
< 300	39	17	0.254	41	0.035
≥ 300	27	13		15
Bleeding (mL)
< 500	42	11	0.632	30	0.881
≥ 500	23	15		33
Intraoperative transfusion
No	58	15	0.005	33	0.056
Yes	8	4		13
Resection status
R0	58	13	0.689	30	0.382
R1/R2	8	13		21
Lymph node status
N0	34		0.011	41	0.020
N1	32	9		17
Tumor size (cm)
< 3	39	18	0.028	42	0.023
≥ 3	27	8		15
pT stage
≤ 2	11		0.293	21	0.949
≥ 3	55	13		33
Multivisceral resection
No	52	15	0.111	33	0.043
Yes	14	10		13
Combined resection
No	50	15	0.474	33	0.303
Yes	16	10		15
Lymphovascular invasion
No	45	11	0.259	23	0.762
Yes	18	18		30
Perineural invasion
No	24	11	0.947	21	0.621
Yes	39	15		27
Neoadjuvant CCRT
Yes	16	15	0.351	33	0.433
No	50	11		21
Preop CA19-9 (U/mL)
< 300	46	15	0.782	27	0.540
≥ 300	16	13		42
Adjuvant treatment
Yes	48	15	0.094	41	0.017
No	18	4		8
Major complications (≥ G3)
No	43	15	0.813	42	0.916
Yes	5	4		21
Use of PCA
Epidural	19	13	0.757	27	0.943
IV	44	15		33
Pain control
Good	53	18	0.001	42	0.001
Poor	13	8		15

¹P values were obtained using a log-rank test. DFS: Disease-free survival; OS: Overall survival; ASA: American Society of Anesthesiologists; MIS: Minimal invasive surgery; CCRT: Concurrent chemoradiotherapy; PCA: Patient-controlled analgesia.