Perioperative blood transfusion is not an independent predictor for worse outcomes in retroperitoneal sarcoma surgery.
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Author
Wong, BoazApte, Sameer S
Tirotta, Fabio
Parente, Alessandro
Mathieu, Johanne
Ford, Sam J
Desai, Anant
Almond, Max
Nessim, Carolyn
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University of Ottawa; Ottawa Hospital Research Institute; University Hospitals Birmingham NHS Foundation Trust; The Ottawa HospitalPublication date
2021-01-13
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Background: Surgery for retroperitoneal soft tissue sarcoma (RPS) is technically challenging, often requiring perioperative red blood cell transfusion (PBT). In other cancers, controversy exists regarding the association of PBT and oncologic outcomes. No study has assessed this association in primary RPS, or identified factors associated with PBT. Methods: Data was collected on all resected primary RPS between 2006 and 2020 at The Ottawa Hospital (Canada) and University Hospital Birmingham (United Kingdom). 'PBT' denotes transfusion given one week before surgery until discharge. Multivariable regression (MVA) identified clinicopathologic factors associated with PBT and assessed PBT association with oncologic outcomes. Surgical complexity was measured using resected organ score (ROS) and patterns of resection. Results: 192 patients were included with 98 (50.8%) receiving PBT. Median follow-up was 38.2 months. High tumour grade (OR 2.20, P = 0.048), preoperative anemia (OR 2.78, P = 0.020), blood loss >1000 mL (OR 4.89, P = 0.004) and ROS >2 (OR 2.29, P = 0.026) were associated with PBT on MVA. A direct linear relationship was observed between higher ROS and increasing units of PBT (β = 0.586, P = 0.038). Increasingly complex patterns of resection were associated with increasing odds of PBT. PBT was associated with severe post-operative complications (P = 0.008) on MVA. Univariable association between PBT and 5-year disease-free or overall survival was lost upon MVA. Conclusions: Surgical complexity and high tumour grade are potentially related to PBT. Oncologic outcomes are not predicted by PBT but are better explained by tumour grade which subsequently may increase surgical complexity. Strategies to reduce PBT should be considered in primary RPS patients.Citation
Wong B, Apte SS, Tirotta F, Parente A, Mathieu J, Ford SJ, Desai A, Almond M, Nessim C. Perioperative blood transfusion is not an independent predictor for worse outcomes in retroperitoneal sarcoma surgery. Eur J Surg Oncol. 2021 Jul;47(7):1763-1770. doi: 10.1016/j.ejso.2021.01.007. Epub 2021 Jan 13.Type
ArticlePMID
33483237Publisher
Elsevierae974a485f413a2113503eed53cd6c53
10.1016/j.ejso.2021.01.007