Perioperative Red Blood Cell Transfusion Is Associated with Poor Long-term Survival in Pancreatic Adenocarcinoma

Anticancer Res. 2017 Oct;37(10):5863-5870. doi: 10.21873/anticanres.12031.

Abstract

Background/aim: Perioperative red blood cell transfusion (RBCT) can negatively affect the host's immune system. We investigated the effects of perioperative RBCT on long-term survival among patients with pancreatic ductal adenocarcinoma (PDAC).

Patients and methods: We retrospectively evaluated 148 patients with PDAC who underwent surgery with curative intent (33 who received RBCTs and 115 who did not). Significant prognostic variables on univariate analysis were subjected to multivariate analyses using a Cox proportional hazard regression model.

Results: Both groups exhibited significant differences in age, preoperative haemoglobin levels, carbohydrate antigen 19-9 levels, maximum tumour size, tumour staging, operative time, intraoperative blood loss, major vascular resection, and the proportion of pancreaticoduodenectomies performed. Patients who underwent RBCTs exhibited significantly poorer overall survival (p<0.001) and recurrence-free survival (p<0.001) compared to patients who did not.

Conclusion: Perioperative RBCT was associated with poorer long-term survival among patients with PDAC who underwent surgery with curative intent.

Keywords: Blood transfusion; pancreatic adenocarcinoma; transfusion-related immune modulation.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Blood Loss, Surgical / mortality
  • Blood Loss, Surgical / prevention & control*
  • Carcinoma, Pancreatic Ductal / mortality
  • Carcinoma, Pancreatic Ductal / pathology
  • Carcinoma, Pancreatic Ductal / surgery*
  • Disease Progression
  • Disease-Free Survival
  • Erythrocyte Transfusion / adverse effects
  • Erythrocyte Transfusion / mortality*
  • Female
  • Humans
  • Intraoperative Care
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Pancreatic Neoplasms / mortality
  • Pancreatic Neoplasms / pathology
  • Pancreatic Neoplasms / surgery*
  • Pancreaticoduodenectomy / adverse effects
  • Pancreaticoduodenectomy / mortality*
  • Propensity Score
  • Proportional Hazards Models
  • Retrospective Studies
  • Risk Factors
  • Time Factors
  • Treatment Outcome