Correlation Between Perioperative Blood Transfusion and Prognosis of Patients Subjected to Surgery for Stage I Lung Cancer

Nosotti, Mario; Rebulla, Paolo; Riccardi, D.; Baisi, Alessandro; Bellaviti, Nadia; Rosso, Lorenzo; Santambrogio, Luigi

doi:10.1378/chest.124.1.102

Cited by 50 publications

(43 citation statements)

References 21 publications

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“…Some authors found transfusion to be a significant independent predictor of earlier recurrence or cancer-related death [16][17][18], whereas others did not [19][20][21][22][23]. Only one prospective study has been carried out to date and has shown that peri-operative blood transfusion was significantly correlated to worse prognosis in patients undergoing lobectomy for stage I nonsmall cell lung cancer [24]. In the present study, great care was taken to exclude patients with comorbidity and other clinical factors pre-operatively identifiable as possible predictors of peri-operative blood transfusion, in order to eliminate confounding factors.…”

Section: Discussionmentioning

confidence: 99%

Impact of blood transfusions on outcome after pneumonectomy for thoracic malignancies

Thomas¹,

Michelet²,

Thirion³

et al. 2007

European Respiratory Journal

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The aim of the present study was to determine the risk factors and impact on outcome of blood transfusions following pneumonectomy for thoracic malignancies.A retrospective analysis of 432 consecutive patients was carried out, of whom 183 (42.4%) were transfused post-operatively. The associations between blood transfusions and 20 variables were assessed by univariate and multivariate analysis. Survival analysis included log-rank test and Cox regression model.Patient age, neoadjuvant treatment, completion pneumonectomy and extended procedures were independent predictors of transfusion. It was found that 30-day mortality increased significantly from 2.4% (no transfusion) to 10.9 and 21.9% (f2 and .2 red blood cell packs, respectively). Blood transfusion was the strongest predictor of 30-day mortality (odds ratio (OR) 10; 95% confidence interval (CI): 3.7-27), respiratory failure (OR 19.2; 95% CI 7.4-49.4) and infectious complications (OR 3; 95% CI 1.5-6.2). In the 367 lung cancer patients, a significantly lower 5-yr survival was observed in univariate analysis of transfused patients (27.8¡5.4% versus 39.4¡4.5%). In a Cox regression analysis, blood transfusion was no longer found to be significant.A dose-related correlation is suggested between blood transfusion and early mortality through an increase of infectious and respiratory complications. In contrast, blood transfusion had no independent adverse impact on long-term survival.

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Section: Discussionmentioning

confidence: 99%

Impact of blood transfusions on outcome after pneumonectomy for thoracic malignancies

Thomas¹,

Michelet²,

Thirion³

et al. 2007

European Respiratory Journal

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show abstract

“…Meta-analyses have attributed the lower survival of transfused patients to a possible negative effect of uncontrolled confounding factors such as comorbidity factors or advanced stage disease. Nosotti et al performed their own observational study in a selected population of stage I NSCLC who underwent the same type of surgery by the same surgical team [33]. Patients with comorbidity or who definitely needed perioperative blood transfusions were excluded from the analysis to eliminate confounding factors.…”

Section: Discussionmentioning

confidence: 99%

Impact of hemoglobin levels on outcomes of adjuvant chemotherapy in resected non-small cell lung cancer: The JBR.10 trial experience

et al. 2007

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“…For centuries, cancer was treated with bloodletting [4,5]-a practice that recently gained unexpected credibility from studies showing that cancer patients survive less long if treated with blood transfusion [6][7][8][9] or recombinant erythropoietin [10,11]. Since cancers often express erythropoietin receptors [12] that inhibit apoptosis [13], promote growth [14], induce new blood vessels (angiogenesis) [15] and intensify drug resistance [16], similar tumor-promoting effects could characterise other cytokines regulating blood supply such as vascular endothelial growth factors (VEGFs) [17].…”

Section: Introductionmentioning

confidence: 99%

VEGF signaling inhibitors: More pro-apoptotic than anti-angiogenic

Epstein

2007

Cancer Metastasis Rev

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The vascular endothelial growth factor (VEGF) family of polypeptide growth factors regulates a family of VEGF receptor (VEGFR) tyrosine kinases with pleiotropic downstream effects. Angiogenesis is the best known of these effects, but additional VEGF-dependent actions include increased vascular permeability, paracrine/autocrine growth factor release, enhancement of cell motility, and inhibition of apoptosis. In theory, therapeutic inhibition of angiogenesis should reduce tumor perfusion and thus increase tumor hypoxia and chemoresistance, but in clinical practice the VEGF antibody bevacizumab acts as a broad-spectrum chemosensitizer. Since VEGFR expression occurs in many tumor types, such chemosensitization is more readily explained by direct inhibition of tumor cell survival signals than by indirect stromal/vascular effects. The emerging model of anti-VEGF drug action being mediated primarily by tumoral (as distinct from endothelial) VEGFRs has clinically important implications for optimizing the anti-metastatic efficacy of this expanding drug class.

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Correlation Between Perioperative Blood Transfusion and Prognosis of Patients Subjected to Surgery for Stage I Lung Cancer

Cited by 50 publications

References 21 publications

Impact of blood transfusions on outcome after pneumonectomy for thoracic malignancies

Impact of blood transfusions on outcome after pneumonectomy for thoracic malignancies

Impact of hemoglobin levels on outcomes of adjuvant chemotherapy in resected non-small cell lung cancer: The JBR.10 trial experience

VEGF signaling inhibitors: More pro-apoptotic than anti-angiogenic

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