Perioperative Transfusions for Gastroesophageal Cancers: Risk Factors and Short- and Long-Term Outcomes
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SSAT POSTER PRESENTATION
Perioperative Transfusions for Gastroesophageal Cancers: Risk Factors and Short- and Long-Term Outcomes Anitha Kammili 1 & Pepa Kaneva 2 & Lawrence Lee 2 & Jonathan Cools-Lartigue 1 & Lorenzo Edwin Ferri 1,2 & Carmen Leandra Mueller 1,2 Received: 1 July 2020 / Accepted: 26 October 2020 # 2020 The Society for Surgery of the Alimentary Tract
Abstract Background Perioperative blood transfusions have been associated with increased morbidity and poorer oncologic outcomes for numerous surgical procedures. However, this issue is understudied among patients with gastroesophageal malignancies. The objective was to clarify the risk factors and impact of perioperative transfusions on quality of life and surgical and oncologic outcomes among patients undergoing gastric and esophageal cancer surgery. Methods Patients undergoing curative-intent resections for gastroesophageal cancers between 2010 and 2018 were included. Perioperative blood transfusion was defined as any transfusion within 24 h pre-operatively, during surgery, or the primary postoperative hospitalization period. Patient and tumor characteristics, surgical and oncological outcomes, and quality of life were compared. Results A total of 435 patients were included. Perioperative transfusions occurred in 184 (42%). Anemia, blood loss, female sex, open surgical approach, and operative time emerged as independent risk factors for transfusions. Factors found to be independently associated with overall survival were neoadjuvant therapy, tumor size and stage, major complications, and mortality. Transfusions did not independently impact overall survival, disease-free survival, or quality of life. Conclusions Perioperative transfusions did not impact oncologic outcomes or quality of life among patients undergoing curativeintent surgery for gastroesophageal cancers. Keywords Esophagus . Gastric . Outcomes . Quality of life . Transfusions
Introduction Gastroesophageal cancer patients are at high risk of anemia due to a multitude of cancer- and treatment-related factors 1. Anemia is often treated with red cell (pRBC) transfusions in this population, especially in the perioperative period for those
Supplementary Information The online version contains supplementary material available at https://doi.org/10.1007/s11605-02004845-7. * Anitha Kammili [email protected] 1
Division of Thoracic and Upper Gastrointestinal Surgery, McGill University Health Centre, Montreal, Canada
2
Division of General Surgery, McGill University Health Centre, Montreal, Canada
undergoing gastroesophagectomy 2. While necessary to preserve life during or after major surgery, transfusions have been associated with increased morbidity, worse oncologic outcomes, and decreased quality of life (QoL) in studies that evaluated patients with other cancers 3–5. Since transfusions have been associated with increased cancer recurrence and risk of developing new tumors 3,4, 6–12 , some question the value of perioperative transfusions in cancer patients 1,8,13–17. The negative effects o
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