Assessing the impact of perioperative blood transfusions on the survival of adults undergoing cytoreductive surgery with hyperthermic intraperitoneal chemotherapy for appendiceal carcinomatosis

Vox Sang. 2017 Aug;112(6):567-577. doi: 10.1111/vox.12546. Epub 2017 Jun 14.

Abstract

Background and objectives: Perioperative red blood cell transfusions (PBT) may be associated with worse survival. In this study of adults undergoing cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS-HIPEC), we investigated whether there was an association between PBT and survival.

Materials and methods: A retrospective study of adults who had undergone CRS-HIPEC for appendiceal carcinomatosis was conducted. Univariate and multivariate analyses were used to identify factors associated with survival.

Results: Of the 270 patients analysed, 170 (63%) received PBT. A PBT was not significantly associated with recurrence-free survival (RFS) (HR = 1·03; 95% CI: 0·7-1·51; P = 0·879) or overall survival (OS) (HR = 0·65; 95% CI: 0·38-1·11; P = 0·116). Higher number of PBT units (≥5) was not associated with worse RFS (P = 0·077) or OS (P = 0·079). Independent predictors of poor survival included as follows: estimated blood loss and high tumour grade for RFS (both P < 0·001), and male gender (P = 0·029) and high tumour grade (P < 0·001) for OS. Higher preoperative haemoglobin was independently associated with better RFS (P = 0·011) and OS (P = 0·006).

Conclusions: In this retrospective study of adults who had undergone CRS-HIPEC for appendiceal carcinomatosis, PBT was not significantly associated with survival.

Keywords: adults; outcomes; perioperative blood transfusion.

MeSH terms

  • Adult
  • Aged
  • Analysis of Variance
  • Antineoplastic Combined Chemotherapy Protocols
  • Appendiceal Neoplasms / surgery
  • Appendiceal Neoplasms / therapy*
  • Blood Loss, Surgical
  • Blood Transfusion*
  • Carcinoma / surgery
  • Carcinoma / therapy*
  • Chemotherapy, Cancer, Regional Perfusion
  • Combined Modality Therapy
  • Cytoreduction Surgical Procedures*
  • Disease-Free Survival
  • Female
  • Follow-Up Studies
  • Humans
  • Hyperthermia, Induced*
  • Male
  • Middle Aged
  • Perioperative Care
  • Retrospective Studies