Perioperative blood transfusion is not an independent predictor for worse outcomes in retroperitoneal sarcoma surgery.

Wong, Boaz, Apte, Sameer S, Tirotta, Fabio, Parente, Alessandro, Mathieu, Johanne, Ford, Sam J, Desai, Anant, Almond, Max and Nessim, Carolyn (2021) Perioperative blood transfusion is not an independent predictor for worse outcomes in retroperitoneal sarcoma surgery. European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology. ISSN 1532-2157. This article is available to all UHB staff and students via ASK Discovery tool http://tinyurl.com/z795c8c by using their UHB Athens login IDs

Full text not available from this repository.
Official URL: http://www.journals.elsevier.com/ejso-european-jou...

Abstract

BACKGROUND

Surgery for retroperitoneal soft tissue sarcoma (RPS) is technically challenging, often requiring perioperative red blood cell transfusion (PBT). In other cancers, controversy exists regarding the association of PBT and oncologic outcomes. No study has assessed this association in primary RPS, or identified factors associated with PBT.

METHODS

Data was collected on all resected primary RPS between 2006 and 2020 at The Ottawa Hospital (Canada) and University Hospital Birmingham (United Kingdom). 'PBT' denotes transfusion given one week before surgery until discharge. Multivariable regression (MVA) identified clinicopathologic factors associated with PBT and assessed PBT association with oncologic outcomes. Surgical complexity was measured using resected organ score (ROS) and patterns of resection.

RESULTS

192 patients were included with 98 (50.8%) receiving PBT. Median follow-up was 38.2 months. High tumour grade (OR 2.20, P = 0.048), preoperative anemia (OR 2.78, P = 0.020), blood loss >1000 mL (OR 4.89, P = 0.004) and ROS >2 (OR 2.29, P = 0.026) were associated with PBT on MVA. A direct linear relationship was observed between higher ROS and increasing units of PBT (β = 0.586, P = 0.038). Increasingly complex patterns of resection were associated with increasing odds of PBT. PBT was associated with severe post-operative complications (P = 0.008) on MVA. Univariable association between PBT and 5-year disease-free or overall survival was lost upon MVA.

CONCLUSIONS

Surgical complexity and high tumour grade are potentially related to PBT. Oncologic outcomes are not predicted by PBT but are better explained by tumour grade which subsequently may increase surgical complexity. Strategies to reduce PBT should be considered in primary RPS patients.

Item Type: Article
Additional Information: This article is available to all UHB staff and students via ASK Discovery tool http://tinyurl.com/z795c8c by using their UHB Athens login IDs
Subjects: QU Biochemistry
QW Microbiology. Immunology
QZ Pathology. Oncology
WO Surgery
Divisions: Planned IP Care > General Surgery
Related URLs:
Depositing User: Jamie Edgar
Date Deposited: 03 Feb 2021 16:26
Last Modified: 03 Feb 2021 16:26
URI: http://www.repository.uhblibrary.co.uk/id/eprint/3937

Actions (login required)

View Item View Item