Association of perioperative transfusion with survival and recurrence after resection of gallbladder cancer: A 10‐institution study from the US Extrahepatic Biliary Malignancy Consortium
Year: 2018
Type: article
Study design: Observational Study
Abstract: BACKGROUND AND OBJECTIVES: Perioperative blood transfusion is associated with poor outcomes in several malignancies. Its effect in gallbladder cancer (GBC) is unknown. METHODS: All patients with GBC who underwent curative-intent resection at 10-institutions from 2000 to 2015 were included. The effect of blood transfusion on overall survival (OS) and recurrence-free (RFS) was evaluated. RESULTS: Of 262 patients with curative-intent resection for GBC, 61 patients (23%) received blood transfusions. Radical cholecystectomy was the most common procedure (80%), but major hepatectomy was more frequent in the transfusion versus no-transfusion group (13% vs 4%; P = 0.02). The transfusion group was less likely to have incidentally discovered disease (57% vs 74%) and receive adjuvant therapy (29% vs 48%), but more likely to have preoperative jaundice (23% vs 11%), T3/T4 tumors (60% vs 39%), LVI (71% vs 40%), PNI (71% vs 48%), and major complications (39% vs 12%) (all P < 0.05). Transfusion was associated with lower median OS compared to no-transfusion (20 vs 32 mos; P < 0.001), which persisted on multivariable (MV) analysis (HR:1.9; 95%CI 1.1-3.5; P = 0.035), controlling for comorbidities, serum albumin, INR, preoperative jaundice, major hepatectomy, incidental discovery, margin status, T-Stage, LN status, and major complications. Median RFS of transfused patients was 13mo compared to 49mo for non-transfused patients (P = 0.1). Transfusion, however, was an independent predictor of decreased RFS on MV analysis (HR:2.3; 95%CI 1.1-5.1; P = 0.035). CONCLUSIONS: Perioperative blood transfusion is associated with decreased OS and RFS after resection for GCC, accounting for other adverse factors. Transfusions should thus be administered with well-defined protocols.
Source: Journal of Surgical Oncology
DOI: 10.1002/jso.25086
Authors: Alexandra G. Lopez‐Aguiar, Cecilia G. Ethun, Mia R. McInnis, Timothy M. Pawlik, George Poultsides, Thuy Tran, Kamran Idrees, Chelsea A. Isom, Ryan C. Fields, Bradley A. Krasnick, Sharon M. Weber, Ahmed Salem, Robert C. G. Martin, Charles R. Scoggins, Perry Shen, Harveshp D. Mogal, Carl Schmidt, Eliza W. Beal, Ioannis Hatzaras, Rivfka Shenoy, Kenneth Cardona, Shishir K. Maithel
Institutions: Emory University, Winship Cancer Institute, Johns Hopkins University, The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, Johns Hopkins Hospital, The Ohio State University, Stanford Medicine, Stanford University, Vanderbilt University, Vanderbilt University Medical Center, Washington University in St. Louis, University of Wisconsin–Madison, University of Louisville, Wake Forest University Health Sciences, Wake Forest University, NYU Langone Health, New York University
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W2885301433