Intraoperative Allogeneic Red Blood Cell Transfusion Negatively Influences Prognosis After Radical Surgery for Pancreatic Cancer: A Propensity Score Matching Analysis. Issue 9 (3rd October 2021)

• Record Type: Journal Article
• Authors: Kanda, Taishu; Wakiya, Taiichi; Ishido, Keinosuke; Kimura, Norihisa; Nagase, Hayato; Kubota, Shunsuke; Fujita, Hiroaki; Hagiwara, Yusuke; Hakamada, Kenichi
• Is Part Of: Pancreas. Volume 50:Issue 9(2021)
• Page Start: 1314
• Page End: 1325
• Publication Date: 2021-10-03
• Subjects: blood transfusion -- propensity score -- pancreatic neoplasms -- transfusion reaction -- adverse effects -- ABT - allogeneic red blood cell transfusion -- ANH - acute normovolemic hemodilution -- CA 19-9 - carbohydrate antigen 19-9 -- CEA - carcinoembryonic antigen -- CI - confidence interval -- CRP - C-reactive protein -- DSS - disease-specific survival -- DUPAN - duke pancreatic monoclonal antigen -- MST - median survival time -- PDAC - pancreatic ductal adenocarcinoma -- PSM - propensity score matching -- RFS - recurrence-free survival -- RR - risk ratio -- ISGPF - International Study Group of Pancreatic Fistula, ISGPS - International Study Group of Pancreatic Surgery -- SPAN - s-pancreas antigen -- UICC - Union for International Cancer Control -- WBC - white blood cell; Pancreas -- Diseases -- Periodicals; Pancreas -- Periodicals; Neuroendocrine tumors -- Periodicals; 616.37005
• DOI: 10.1097/MPA.0000000000001913
• Languages: English
• ISSNs: 0885-3177

Abstract

Abstract : Objective: We aimed to investigate the real impact of allogeneic red blood cell transfusion (ABT) on postoperative outcomes in resectable pancreatic ductal adenocarcinoma (PDAC) patients. Methods: Of 128 patients undergoing resectable PDAC surgery at our facility, 24 (18.8%) received ABT. Recurrence-free survival (RFS) and disease-specific survival (DSS), before and after propensity score matching (PSM), were compared among patients who did and did not receive ABT. Results: In the entire cohort, ABT was significantly associated with decreased RFS ( P = 0.002) and DSS ( P = 0.014) before PSM. Cox regression analysis identified ABT (risk ratio, 1.884; 95% confidence interval, 1.015–3.497; P = 0.045) as an independent prognostic factor for RFS. Univariate and multivariate analysis identified preoperative hemoglobin value, preoperative total bilirubin value, and intraoperative blood loss as significant independent risk factors for ABT. Using these 3 variables, PSM analysis created 16 pairs of patients. After PSM, the ABT group had significantly poorer RFS rates than the non-ABT group (median, 9.8 vs 15.8 months, P = 0.022). Similar tendencies were found in DSS rates (median, 19.4 vs 40.0 months, P = 0.071). Conclusions: This study revealed certain negative effects of intraoperative ABT on postoperative survival outcomes in patients with resectable PDAC.