Impact of perioperative blood transfusion on clinical outcomes in patients with colorectal liver metastasis after hepatectomy: a meta-analysis

Lyu, Xinghua; Qiao, Wenhui; Li, Debang; Leng, Yufang

doi:10.18632/oncotarget.16771

Cited by 34 publications

(34 citation statements)

References 37 publications

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“…A recent meta-analysis by Lyu et al[9] examined the outcomes of patients who received a hepatectomy for CRC metastasis. The analysis included 10621 patients, and the authors found that transfused patients had higher overall morbidity (OR = 1.98), higher mortality (OR = 4.13), longer hospital stays (OR = 4.43), reduced overall survival (RR = 1.24), and reduced disease-free survival (RR = 1.38).…”

Section: Discussionmentioning

confidence: 99%

“…However, these patients are at an increased risk for a perioperative transfusion, and thus the effect of a transfusion on surgical and oncological outcomes is an area of study. A number of studies have indicated that patients with CRC undergoing colon resection and/or surgical treatment of liver metastasis who receive a perioperative allogeneic transfusion have increased mortality, reduced overall survival, reduced disease free survival, more postoperative complications, and longer length of hospital stay[4,9-12]. Studies, however, have not been consistent in all of their findings.…”

Section: Introductionmentioning

confidence: 99%

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Impact of perioperative transfusion in patients undergoing resection of colorectal cancer liver metastases: A population-based study

Long

Xiao

Shang

et al. 2019

WJCC

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BACKGROUND Perioperative allogeneic blood transfusion is associated with poorer outcomes. AIM To identify the factors that were associated with perioperative transfusion and to examine the impact of perioperative transfusion in patients undergoing resection of colorectal cancer (CRC) liver metastases. METHODS The United States National Inpatient Sample (NIS) database was searched for patients with CRC who received surgery for liver metastasis. Linear and logistic regression analyses were performed. RESULTS A total of 2018 patients were included, and 480 had a perioperative transfusion. Emergency admission (adjusted odds ratio [aOR] = 1.42; 95%CI: 1.07-1.87), hepatic lobectomy (aOR = 1.76; 95%CI: 1.42-2.19), and chronic anemia (aOR = 2.62; 95%CI: 2.04-3.35) were associated with increased chances of receiving a transfusion, but receiving surgery at a teaching hospital (aOR = 0.75; 95%CI: 0.58-0.98) was associated with a decreased chance of receiving a transfusion. Receiving a perioperative transfusion was significantly associated with increased in-hospital mortality (aOR = 3.38; 95%CI: 1.57-7.25), and increased overall postoperative complications (aOR = 1.67; 95%CI: 1.31-2.13), as well as longer length of hospital stay CONCLUSION Patients with an emergency admission, hepatic lobectomy, chronic anemia, and who have surgery at a non-teaching hospital are more likely to receive a perioperative transfusion. Patients with CRC undergoing surgery for hepatic metastases who receive a perioperative transfusion are at a higher risk of in-hospital mortality, postoperative complications, and longer length of hospital stay.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Impact of perioperative transfusion in patients undergoing resection of colorectal cancer liver metastases: A population-based study

Long

Xiao

Shang

et al. 2019

WJCC

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“…Likewise, a lower Hb-value was recently reported by our center as negative predictor for survival [ 18 ]. Furthermore, a lower Hb-value might cause an increased need for perioperative blood transfusion, lately reported to impair disease-free and overall survival [ 19 , 20 ]. The Quick's value in % was not described previously as prognostic factor in liver resection for colorectal liver metastases but it appears logical that a higher value correlates with a better synthetic function of the organ and a more stable function of the liver remnant after resection.…”

Section: Discussionmentioning

confidence: 99%

Proposal of Two Prognostic Models for the Prediction of 10-Year Survival after Liver Resection for Colorectal Metastases

et al. 2018

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Background One-third of 5-year survivors after liver resection for colorectal liver metastases (CLM) develop recurrence or tumor-related death. Therefore 10-year survival appears more adequate in defining permanent cure. The aim of this study was to develop prognostic models for the prediction of 10-year survival after liver resection for colorectal liver metastases. Methods N=965 cases of liver resection for CLM were retrospectively analyzed using univariable and multivariable regression analyses. Receiver operating curve analyses were used to assess the sensitivity and specificity of developed prognostic models and their potential clinical usefulness. Results The 10-year survival rate was 15.2%. Age at liver resection, application of chemotherapies of the primary tumor, preoperative Quick's value, hemoglobin level, and grading of the primary colorectal tumor were independent significant predictors for 10-year patient survival. The generated formula to predict 10-year survival based on these preoperative factors displayed an area under the receiver operating curve (AUROC) of 0.716. In regard to perioperative variables, the distance of resection margins and performance of right segmental liver resection were additional independent predictors for 10-year survival. The logit link formula generated with pre- and perioperative variables showed an AUROC of 0.761. Conclusion Both prognostic models are potentially clinically useful (AUROCs >0.700) for the prediction of 10-year survival. External validation is required prior to the introduction of these models in clinical patient counselling.

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“…Anaemia may shorten survival time in cancer patients and worsen local tumour control . In addition, meta‐analyses in different types of cancer show that red cell transfusions increase the risk of tumour recurrence and decrease survival rates . Pre‐operative anaemia in patients for colorectal cancer surgery is common (30–67%) and is a cause for concern .…”

Section: Who?mentioning

confidence: 99%

Optimisation of pre‐operative anaemia in patients before elective major surgery – why, who, when and how?

2019

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Anaemia in surgical patients is a common and serious problem; around 40% of patients presenting for major surgery are anaemic. Patients with pre-operative anaemia have significantly higher rates of morbidity and mortality and are likely to be transfused red cells. In addition, red cell transfusions are independently associated with worse outcomes. Pre-optimisation of anaemia in surgical patients leads to higher pre-operative haemoglobin concentrations and less need for transfusion. Patients undergoing major surgery (defined as blood loss > 500 ml expected or possible) should be optimised if their haemoglobin concentration is less than 130 g.l À1 on screening. Detection of anaemia should follow listing for surgery as soon as possible to allow enough time for optimisation. The most common cause of pre-operative anaemia is iron deficiency, which can be treated with iron therapy. Iron clinics should be set up in either primary or secondary care to allow for optimal treatment. In this review, we present literature supporting the optimisation of pre-operative anaemia and propose a treatment algorithm.

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Impact of perioperative blood transfusion on clinical outcomes in patients with colorectal liver metastasis after hepatectomy: a meta-analysis

Cited by 34 publications

References 37 publications

Impact of perioperative transfusion in patients undergoing resection of colorectal cancer liver metastases: A population-based study

Impact of perioperative transfusion in patients undergoing resection of colorectal cancer liver metastases: A population-based study

Proposal of Two Prognostic Models for the Prediction of 10-Year Survival after Liver Resection for Colorectal Metastases

Optimisation of pre‐operative anaemia in patients before elective major surgery – why, who, when and how?

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