Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Wisconsin, 600 Highland Ave, Madison, WI, 53792, USA.
University of Michigan, Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, 1500 E. Medical Center Drive, Ann Arbor, MI, 48109-5276, USA.
BMC Cancer. 2018 Oct 26;18(1):1041. doi: 10.1186/s12885-018-4882-8.
The oncologic safety of allogeneic blood transfusion in ovarian cancer patients is unknow. We sought to determine the prevalence and oncologic safety of perioperative allogeneic blood transfusion during interval cytoreduction surgery among women receiving neoadjuvant chemotherapy for ovarian cancer.
We utilized retrospective chart review to identify a cohort of patients undergoing interval cytoreduction at a large academic tertiary referral center. We compared outcomes in patients who were exposed to perioperative blood transfusion compared with patients who were not exposed. Our primary endpoint was progression free survival; our secondary endpoint was overall survival. Baseline clinical characteristics were collected for patients in each group.
Sixty-six women were included in the final cohort of women undergoing interval cytoreductive surgery after NACT. A total of 51 women (77%) were exposed to allogeneic perioperative pRBC transfusion. Fifteen women (23%) were not exposed to transfusion. The baseline characteristics were generally well matched. Women who were not exposed to a perioperative blood transfusion were more likely to have a normalized CA125 prior to undergoing cytoreductive surgery. Preoperative hemoglobin concentration was lower in the transfusion group (10.5 g/dLvs 11.5 g/dL, p < 0.009). Perioperative transfusion was not associated with a significant difference in progression free survival (PFS = 7.6 months for transfused, 9.4 months for not transfused; log-rank test p = 0.4617). Similarly, there was no observed difference between groups for overall survival (OS = 23.6 months for transfused, 22.5 months for not transfused; log-rank test p = 0.1723).
Women undergoing neoadjuvant chemotherapy for ovarian cancer are at high risk of exposure to blood transfusion at the time of interval cytoreductive surgery. Future studies will continue to evaluate the safety and impact of transfusion on ovarian cancer survival in this at risk population.
异体输血在卵巢癌患者中的肿瘤安全性尚不清楚。我们旨在确定在接受新辅助化疗的卵巢癌患者中，在间隔减瘤手术期间接受异体输血的流行率和肿瘤安全性。
我们利用回顾性图表审查，确定了在一家大型学术三级转诊中心进行间隔减瘤手术的患者队列。我们比较了接受围手术期输血的患者与未接受输血的患者的结局。我们的主要终点是无进展生存期；次要终点是总生存期。为每组患者收集了基线临床特征。
最终纳入了 66 名接受新辅助化疗后间隔减瘤手术的女性患者。共有 51 名女性（77%）接受了异体围手术期红细胞输血。15 名女性（23%）未接受输血。基线特征总体上匹配良好。未接受围手术期输血的女性在接受减瘤手术前 CA125 更有可能恢复正常。输血组的术前血红蛋白浓度较低（10.5 g/dL 对 11.5 g/dL，p < 0.009）。围手术期输血与无进展生存期（输血组为 7.6 个月，未输血组为 9.4 个月；对数秩检验 p = 0.4617）无显著差异。同样，两组之间的总生存期也没有观察到差异（输血组为 23.6 个月，未输血组为 22.5 个月；对数秩检验 p = 0.1723）。
接受新辅助化疗的卵巢癌女性在接受间隔减瘤手术时异体输血的风险很高。未来的研究将继续评估在该高危人群中输血对卵巢癌生存的安全性和影响。
