Cannabis use disorder was not linked to worse outcomes after complex cancer surgery | Research

The takeaway

Among 15,014 matched patients undergoing high-risk cancer surgery, cannabis use disorder was not independently associated with higher overall morbidity and mortality.

Surgical oncologists, anesthesiologists, perioperative specialists, and cancer patients who use cannabis.

What the researchers found

After propensity score matching, CUD was associated with slightly higher AKI (7.8% vs 6.1%) but lower in-hospital mortality (0.9% vs 1.6%). On multivariable analysis, CUD was not associated with higher overall morbidity and mortality (aOR 1.06, 95% CI 0.98-1.15, p=0.158).

Why it matters

Cancer patients increasingly use cannabis. The finding that CUD does not independently worsen complex surgical outcomes may reassure patients and surgeons, though the kidney injury signal warrants monitoring.

The numbers in context

15,014 patients. AKI: 7.8% vs 6.1%. Mortality: 0.9% vs 1.6%. Adjusted composite: aOR 1.06 (p=0.158).

How the study worked

Retrospective cohort using National Inpatient Sample (2016-2019). 15,014 patients after 1:1 propensity score matching on comorbidities, demographics, and procedure type.

What this study cannot tell us

ICD-10 codes for CUD may undercount use. Cannot distinguish active from historical diagnosis. Cannot assess dose or recency.

How to read the evidence

Large propensity-matched cohort from national database with appropriate adjustment. Administrative data limitations apply.

When this study was published

2024 publication using 2016-2019 data.

The bigger picture

This is the largest propensity-matched study of CUD and complex cancer surgery. The null overall finding suggests CUD is not the perioperative risk factor some feared.

Questions still open

What mechanism explains the slightly higher AKI risk?
Would results differ if active use could be identified?

Common questions

Is cancer surgery safe if you use cannabis?

This large study found CUD was not independently linked to worse overall outcomes. Kidney injury was slightly elevated, and disclosure to your team remains important.

Why was mortality lower in the cannabis group?

CUD patients were younger on average. After adjusting for all factors, there was no significant difference in the composite outcome.

Read the original research

Cannabis use disorder and perioperative outcomes following complex cancer surgery.

Journal of surgical oncology, 129(8), 1430-1441

View on PubMed ↗Publisher’s paper ↗

Citation

Munir, Muhammad M; Woldesenbet, Selamawit; Endo, Yutaka; Dillhoff, Mary; Pawlik, Timothy M. (2024). Cannabis use disorder and perioperative outcomes following complex cancer surgery.. Journal of surgical oncology, 129(8), 1430-1441. https://doi.org/10.1002/jso.27644