Adverse oncologic effects of intraoperative transfusion during pancreatectomy for left-sided pancreatic cancer: the need for strict transfusion policy

Ho Kyoung Hwang, Myung Jae Jung, Sung Hwan Lee, Chang Moo Kang, Woo Jung Lee

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Background: The aim of the present study was to investigate the prognostic impact of transfusion following distal pancreatectomy (DP) for left-sided pancreatic ductal adenocarcinoma (PDAC). Methods: Retrospective analysis was performed to identify prognostic factors in patients who underwent DP from July 1992 to October 2012. Results: Forty-eight patients were male, and 35 were female with a mean age of 62 ± 9 years. Twenty-three (27.7%) of the patients received intraoperative blood transfusion. In univariate analysis, combined organ resection (P = 0.046), intraoperative transfusion (P < 0.001), pathologic tumor size (≥3 cm, P = 0.051), clinical tumor size (≥3 cm, P = 0.008), lymph node metastasis (P = 0.021), lymph node ratio (LNR ≥ 0.017, P < 0.001), and tumor differentiation (P = 0.013) were analyzed to predict tumor recurrence. Multivariate analysis showed that lymph node metastasis (Exp(β) = 2.136, P = 0.016), LNR (Exp(β) = 2.003, P = 0.049), and intraoperative transfusion (Exp(β) = 2.793, P = 0.001) were independent prognostic factor predicting tumor recurrence. The amount of estimated blood loss was closely associated with intraoperative transfusion (P < 0.001). Conclusion: Intraoperative transfusion should be avoided by gentle operative handling to minimize intraoperative bleeding, and the appropriate transfusion policy should be followed to increase the survival outcome.

Original languageEnglish
Pages (from-to)497-507
Number of pages11
JournalJournal of Hepato-Biliary-Pancreatic Sciences
Volume23
Issue number8
DOIs
Publication statusPublished - 2016 Aug 1

Fingerprint

Pancreatectomy
Pancreatic Neoplasms
Lymph Nodes
Neoplasms
Neoplasm Metastasis
Recurrence
Blood Transfusion
Adenocarcinoma
Multivariate Analysis
Hemorrhage
Survival

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

@article{6337c5ad7ba64e309be604fb03dfc1e9,
title = "Adverse oncologic effects of intraoperative transfusion during pancreatectomy for left-sided pancreatic cancer: the need for strict transfusion policy",
abstract = "Background: The aim of the present study was to investigate the prognostic impact of transfusion following distal pancreatectomy (DP) for left-sided pancreatic ductal adenocarcinoma (PDAC). Methods: Retrospective analysis was performed to identify prognostic factors in patients who underwent DP from July 1992 to October 2012. Results: Forty-eight patients were male, and 35 were female with a mean age of 62 ± 9 years. Twenty-three (27.7{\%}) of the patients received intraoperative blood transfusion. In univariate analysis, combined organ resection (P = 0.046), intraoperative transfusion (P < 0.001), pathologic tumor size (≥3 cm, P = 0.051), clinical tumor size (≥3 cm, P = 0.008), lymph node metastasis (P = 0.021), lymph node ratio (LNR ≥ 0.017, P < 0.001), and tumor differentiation (P = 0.013) were analyzed to predict tumor recurrence. Multivariate analysis showed that lymph node metastasis (Exp(β) = 2.136, P = 0.016), LNR (Exp(β) = 2.003, P = 0.049), and intraoperative transfusion (Exp(β) = 2.793, P = 0.001) were independent prognostic factor predicting tumor recurrence. The amount of estimated blood loss was closely associated with intraoperative transfusion (P < 0.001). Conclusion: Intraoperative transfusion should be avoided by gentle operative handling to minimize intraoperative bleeding, and the appropriate transfusion policy should be followed to increase the survival outcome.",
author = "Hwang, {Ho Kyoung} and Jung, {Myung Jae} and Lee, {Sung Hwan} and Kang, {Chang Moo} and Lee, {Woo Jung}",
year = "2016",
month = "8",
day = "1",
doi = "10.1002/jhbp.368",
language = "English",
volume = "23",
pages = "497--507",
journal = "Journal of Hepato-Biliary-Pancreatic Sciences",
issn = "1868-6974",
publisher = "Springer Verlag",
number = "8",

}

Adverse oncologic effects of intraoperative transfusion during pancreatectomy for left-sided pancreatic cancer : the need for strict transfusion policy. / Hwang, Ho Kyoung; Jung, Myung Jae; Lee, Sung Hwan; Kang, Chang Moo; Lee, Woo Jung.

In: Journal of Hepato-Biliary-Pancreatic Sciences, Vol. 23, No. 8, 01.08.2016, p. 497-507.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Adverse oncologic effects of intraoperative transfusion during pancreatectomy for left-sided pancreatic cancer

T2 - the need for strict transfusion policy

AU - Hwang, Ho Kyoung

AU - Jung, Myung Jae

AU - Lee, Sung Hwan

AU - Kang, Chang Moo

AU - Lee, Woo Jung

PY - 2016/8/1

Y1 - 2016/8/1

N2 - Background: The aim of the present study was to investigate the prognostic impact of transfusion following distal pancreatectomy (DP) for left-sided pancreatic ductal adenocarcinoma (PDAC). Methods: Retrospective analysis was performed to identify prognostic factors in patients who underwent DP from July 1992 to October 2012. Results: Forty-eight patients were male, and 35 were female with a mean age of 62 ± 9 years. Twenty-three (27.7%) of the patients received intraoperative blood transfusion. In univariate analysis, combined organ resection (P = 0.046), intraoperative transfusion (P < 0.001), pathologic tumor size (≥3 cm, P = 0.051), clinical tumor size (≥3 cm, P = 0.008), lymph node metastasis (P = 0.021), lymph node ratio (LNR ≥ 0.017, P < 0.001), and tumor differentiation (P = 0.013) were analyzed to predict tumor recurrence. Multivariate analysis showed that lymph node metastasis (Exp(β) = 2.136, P = 0.016), LNR (Exp(β) = 2.003, P = 0.049), and intraoperative transfusion (Exp(β) = 2.793, P = 0.001) were independent prognostic factor predicting tumor recurrence. The amount of estimated blood loss was closely associated with intraoperative transfusion (P < 0.001). Conclusion: Intraoperative transfusion should be avoided by gentle operative handling to minimize intraoperative bleeding, and the appropriate transfusion policy should be followed to increase the survival outcome.

AB - Background: The aim of the present study was to investigate the prognostic impact of transfusion following distal pancreatectomy (DP) for left-sided pancreatic ductal adenocarcinoma (PDAC). Methods: Retrospective analysis was performed to identify prognostic factors in patients who underwent DP from July 1992 to October 2012. Results: Forty-eight patients were male, and 35 were female with a mean age of 62 ± 9 years. Twenty-three (27.7%) of the patients received intraoperative blood transfusion. In univariate analysis, combined organ resection (P = 0.046), intraoperative transfusion (P < 0.001), pathologic tumor size (≥3 cm, P = 0.051), clinical tumor size (≥3 cm, P = 0.008), lymph node metastasis (P = 0.021), lymph node ratio (LNR ≥ 0.017, P < 0.001), and tumor differentiation (P = 0.013) were analyzed to predict tumor recurrence. Multivariate analysis showed that lymph node metastasis (Exp(β) = 2.136, P = 0.016), LNR (Exp(β) = 2.003, P = 0.049), and intraoperative transfusion (Exp(β) = 2.793, P = 0.001) were independent prognostic factor predicting tumor recurrence. The amount of estimated blood loss was closely associated with intraoperative transfusion (P < 0.001). Conclusion: Intraoperative transfusion should be avoided by gentle operative handling to minimize intraoperative bleeding, and the appropriate transfusion policy should be followed to increase the survival outcome.

UR - http://www.scopus.com/inward/record.url?scp=84982274135&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84982274135&partnerID=8YFLogxK

U2 - 10.1002/jhbp.368

DO - 10.1002/jhbp.368

M3 - Article

C2 - 27295957

AN - SCOPUS:84982274135

VL - 23

SP - 497

EP - 507

JO - Journal of Hepato-Biliary-Pancreatic Sciences

JF - Journal of Hepato-Biliary-Pancreatic Sciences

SN - 1868-6974

IS - 8

ER -