Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, Tokyo 105-8461, Japan.
Anticancer Res. 2013 Sep;33(9):4041-7.
Excessive blood loss and blood transfusion may influence postoperative complications and prognosis of patients after pancreatic resection. We evaluated the influence of blood products use on postoperative recurrence and outcome of patients with pancreatic ductal adenocarcinoma.
The study included 82 patients who underwent elective pancreatic resections for pancreatic ductal adenocarcinoma without distant metastasis or other malignancies between January 2001 and December 2010. We retrospectively investigated the influence of the use of perioperative blood products including red cell concentrate, fresh-frozen plasma (FFP), and albumin preparation, and clinical variables regarding disease-free and overall survival.
In disease-free survival, serum carcinoembryonic antigen more than 10 ng/ml (p=0.015), serum carbohydrate antigen 19-9 (CA19-9) more than 200 U/ml (p=0.0032), R1 resection (p=0.005), and FFP transfusion were independent risk factors for cancer recurrence in the Cox proportional regression model, pancreaticoduodenectomy (p=0.057) and advanced tumor stage (p=0.083) tended to associate with poor disease-free survival, but were not statistically significant. In overall survival, male gender (p=0.012), advanced tumor stage (p=0.005), serum CA19-9 more than 200 U/ml (p<0.001), and FFP transfusion (p=0.003) were positively associated with poor overall survival in the Cox proportional regression model.
FFP transfusion is associated with poor therapeutic outcome after elective pancreatic resection for pancreatic ductal adenocarcinoma.
术中失血过多和输血可能会影响胰腺切除术后患者的术后并发症和预后。我们评估了血液制品的使用对胰腺导管腺癌患者术后复发和结局的影响。
本研究纳入了 82 例 2001 年 1 月至 2010 年 12 月期间接受择期胰腺切除术且无远处转移或其他恶性肿瘤的胰腺导管腺癌患者。我们回顾性调查了围手术期血液制品（包括浓缩红细胞、新鲜冷冻血浆（FFP）和白蛋白制剂）的使用以及与无病生存和总生存相关的临床变量对疾病无复发生存和总生存的影响。
在无病生存方面，血清癌胚抗原大于 10ng/ml（p=0.015）、血清碳水化合物抗原 19-9（CA19-9）大于 200U/ml（p=0.0032）、R1 切除（p=0.005）和 FFP 输血是 Cox 比例风险回归模型中癌症复发的独立危险因素，胰十二指肠切除术（p=0.057）和晚期肿瘤分期（p=0.083）倾向于与无病生存不良相关，但无统计学意义。在总生存方面，男性（p=0.012）、晚期肿瘤分期（p=0.005）、血清 CA19-9 大于 200U/ml（p<0.001）和 FFP 输血（p=0.003）在 Cox 比例风险回归模型中与总生存不良呈正相关。
FFP 输血与胰腺导管腺癌患者择期胰腺切除术后治疗效果不良相关。
