• Tak Kyu Oh, Woo Jin Lee, Sang Myung Woo, Nam Woo Kim, Jiyeon Yim, and Dae Hyun Kim.
• Department of Anesthesiology and Pain Medicine, National Cancer Center, Goyang, Republic of Korea.
• Pain Physician. 2017 Mar 1; 20 (3): E357-E365.

BackgroundPain 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.ObjectivesTo determine if CPN is associated with survival benefits for these patients.Study DesignRetrospective, observational cohort study.SettingNational Cancer Center in Korea.MethodsThe 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.ResultsFor 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).LimitationsRetrospective design, small sample size, and inconsistent timing of CPN after the diagnosis date.ConclusionCPN 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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