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新鲜冷冻血浆输注对结直肠癌肝转移术后预后的负面影响。

Negative impact of fresh-frozen plasma transfusion on prognosis after hepatic resection for liver metastases from colorectal cancer.

机构信息

Department of Surgery, School of Medicine, Jikei University, Minato-ku, Tokyo, Japan.

出版信息

Anticancer Res. 2013 Jun;33(6):2723-8.

Abstract

BACKGROUND

In perioperative management of hepatic resection for colorectal cancer liver metastasis (CRLM), excessive blood loss and blood transfusion greatly influence postoperative complications and prognosis of the patients. We evaluated the influence of the use of blood products on prognosis of patients with CRLM.

PATIENTS AND METHODS

The subjects of this study were 65 patients who underwent elective hepatic resection between January 2001 and April 2011 for CRLM without distant metastasis or other malignancy. We retrospectively investigated the influence of the use of blood products, including red cell concentrate (RC) and fresh frozen plasma (FFP), and clinical variables on overall survival.

RESULTS

In univariate analysis, bilobar distribution (p=0.0332), more than four lymph node metastases of the primary cancer (p=0.0155), perioperative RC use (p=0.0205), and perioperative FFP use (p=0.0065) were positively associated with poor overall survival rate. In multivariate analysis, bilobar distribution (p=0.0012), more than four lymph node metastases of the primary cancer (p=0.0171), and perioperative FFP use (p=0.0091), were independent risk factors for poor overall survival rate.

CONCLUSION

The use of FFP is associated with worse overall survival after elective hepatic resection for patients with CRLM.

摘要

背景

在结直肠癌肝转移(CRLM)的肝切除围手术期管理中,大量失血和输血会极大地影响患者的术后并发症和预后。我们评估了血液制品的使用对 CRLM 患者预后的影响。

患者与方法

本研究的对象为 65 例于 2001 年 1 月至 2011 年 4 月期间因无远处转移或其他恶性肿瘤而接受择期肝切除术治疗的 CRLM 患者。我们回顾性地调查了血液制品(包括浓缩红细胞(RC)和新鲜冷冻血浆(FFP))的使用以及临床变量对总生存率的影响。

结果

单因素分析显示,双叶分布(p=0.0332)、原发癌的淋巴结转移数超过 4 个(p=0.0155)、围手术期 RC 使用(p=0.0205)和围手术期 FFP 使用(p=0.0065)与总生存率差呈正相关。多因素分析显示,双叶分布(p=0.0012)、原发癌的淋巴结转移数超过 4 个(p=0.0171)和围手术期 FFP 使用(p=0.0091)是总生存率差的独立危险因素。

结论

在 CRLM 患者择期肝切除术后,FFP 的使用与总生存率降低相关。

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