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01-09-2014 | SSAT Quick Shot Presentation

Perioperative Blood Transfusion Is Associated with Decreased Survival in Patients Undergoing Pancreaticoduodenectomy for Pancreatic Adenocarcinoma: a Multi-institutional Study

Authors: Jeffrey M. Sutton, David A. Kooby, Gregory C. Wilson, M. Hart Squires III, Dennis J. Hanseman, Shishir K. Maithel, David J. Bentrem, Sharon M. Weber, Clifford S. Cho, Emily R. Winslow, Charles R. Scoggins, Robert C. G. Martin II, Hong Jin Kim, Justin J. Baker, Nipun B. Merchant, Alexander A. Parikh, Daniel E. Abbott, Michael J. Edwards, Syed A. Ahmad

Published in: Journal of Gastrointestinal Surgery | Issue 9/2014

Abstract

Introduction

In this multi-institutional study of patients undergoing pancreaticoduodenectomy for pancreatic adenocarcinoma, we sought to identify factors associated with perioperative transfusion requirement as well as the association between blood transfusion and perioperative and oncologic outcomes.

Methods

The surgical databases across six high-volume institutions were analyzed to identify patients who underwent pancreaticoduodenectomy for pancreatic adenocarcinoma from 2005 to 2010. For statistical analyses, patients were then stratified by transfusion volume according to whether they received 0, 1–2, or >2 units of packed red blood cells.

Results

Among 697 patients identified, 42 % required blood transfusion. Twenty-three percent received 1–2 units, and 19 % received >2 units. Factors associated with an increased transfusion requirement included older age, heart disease, diabetes, longer operative time, higher blood loss, tumor size, and non-R0 margin status (all p < 0.05). The median disease-free survival (13.8 vs. 18.3 months, p = 0.02) and overall survival (14.0 vs. 21.0 months, p < 0.0001) durations of transfused patients were shorter than those of transfusion-free patients. Multivariate modeling identified intraoperative transfusion of >2 units (hazard ratio, 1.92, p = 0.009) and postoperative transfusions as independent factors associated with decreased disease-free survival.

Conclusions

This multi-institutional study represents the largest series to date analyzing the effects of perioperative blood transfusion on patient outcomes following pancreaticoduodenectomy for pancreatic adenocarcinoma. While blood transfusion was not associated with increased rate of infectious complications, allogeneic blood transfusion did confer a negative impact on disease-free and overall survival.

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Title: Perioperative Blood Transfusion Is Associated with Decreased Survival in Patients Undergoing Pancreaticoduodenectomy for Pancreatic Adenocarcinoma: a Multi-institutional Study
Authors: Jeffrey M. Sutton
David A. Kooby
Gregory C. Wilson
M. Hart Squires III
Dennis J. Hanseman
Shishir K. Maithel
David J. Bentrem
Sharon M. Weber
Clifford S. Cho
Emily R. Winslow
Charles R. Scoggins
Robert C. G. Martin II
Hong Jin Kim
Justin J. Baker
Nipun B. Merchant
Alexander A. Parikh
Daniel E. Abbott
Michael J. Edwards
Syed A. Ahmad
Publication date: 01-09-2014
Publisher: Springer US
Published in: Journal of Gastrointestinal Surgery / Issue 9/2014
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI: https://doi.org/10.1007/s11605-014-2567-4

At a glance: The STEP trials

Springer Medicine

Perioperative Blood Transfusion Is Associated with Decreased Survival in Patients Undergoing Pancreaticoduodenectomy for Pancreatic Adenocarcinoma: a Multi-institutional Study

Abstract

Introduction

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusions

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