LAS TRANSFUSIONES DE SANGRE PERIOPERATORIAS SE ASOCIAN CON UNA PEOR SOBREVIDA GLOBAL, PERO NO CON LA SOBREVIDA LIBRE DE ENFERMEDAD POSTERIOR A LA RESECCIÓN CURATIVA DEL CÁNCER DE RECTO: UN PUNTAJE DE PROPENSIÓN POR ANÁLISIS DE CONCORDANCIA

Translated title of the contribution: Perioperative Blood Transfusions Are Associated with Worse Overall Survival but Not Disease-Free Survival after Curative Rectal Cancer Resection: A Propensity Score-Matched Analysis

David N. Hanna, Adriana C. Gamboa, Glen C. Balch, Scott E. Regenbogen, Jennifer Holder-Murray, Sherif R.Z. Abdel-Misih, Matthew L. Silviera, Michael P. Feng, Thomas G. Stewart, Li Wang, Alexander T. Hawkins

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

BACKGROUND: The effects of blood transfusions on oncologic outcomes after surgery remain inconclusive. Thus, we examined the association between receiving a perioperative blood transfusion and oncologic outcomes in patients undergoing curative rectal cancer resection. OBJECTIVE: The purpose of this study was to assess the association between receiving a perioperative blood transfusion with disease-free and overall survival in patients undergoing curative resection of clinical stage I to III rectal cancer. We hypothesized that blood transfusion is associated with worse disease-free and overall survival in this patient cohort. DESIGN: This was a retrospective cohort study using a propensity score-matched analysis. SETTINGS: The study involved 6 tertiary academic medical centers in the United States contributing to the United States Rectal Cancer Consortium. PATIENTS: Patients who underwent curative resection for rectal cancer from 2010 to 2018 were included. MAIN OUTCOME MEASURES: The primary outcome was disease-free survival. The secondary outcomes were overall survival, intensive care unit length of stay, hospital length of stay, surgical site infection, and readmission. RESULTS: Of the 924 patients eligible for matching, 312 patients were matched, including 100 patients who received a transfusion and 212 who did not. In a propensity score-matched analysis, receiving a perioperative blood transfusion was not associated with worse 5-year disease-free survival (transfused, 78%; not transfused, 83%; p = 0.32) but was associated with worse 5-year overall survival (transfused 65% vs not transfused 86%; p < 0.001) and increased hospital length of stay (transfused, 9.9 d; not transfused, 7.6 d; p = 0.001). LIMITATIONS: Despite propensity matching, confounding may remain. Propensity matching may limit the power to detect a difference in disease-free survival. CONCLUSIONS: Receiving a perioperative blood transfusion is not associated with worse disease-free survival but is associated with worse overall survival. Such findings are important for clinicians and patients to understand when considering perioperative blood transfusions. See Video Abstract at http://links.lww.com/DCR/B531.

Translated title of the contributionPerioperative Blood Transfusions Are Associated with Worse Overall Survival but Not Disease-Free Survival after Curative Rectal Cancer Resection: A Propensity Score-Matched Analysis
Original languageSpanish
Pages (from-to)946-954
Number of pages9
JournalDiseases of the Colon and Rectum
DOIs
StateAccepted/In press - 2021
Externally publishedYes

Keywords

  • Blood transfusions
  • Outcomes
  • Perioperative care
  • Propensity score
  • Rectal cancer

ASJC Scopus subject areas

  • Gastroenterology

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