Brandenburg Leonard Simon, Metzger Marc Christian, Poxleitner Philipp, Voss Pit Jacob, Vach Kirstin, Hell Johannes, Hasel Konstantin, Weingart Julia Vera, Schwarz Steffen Jochen, Ermer Michael Andreas
Department of Oral and Maxillofacial Surgery, Clinic, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetterstr. 55, 79106 Freiburg, Germany.
Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Zinkmattenstr. 6A, 79108 Freiburg, Germany.
Cancers (Basel). 2021 Dec 28;14(1):138. doi: 10.3390/cancers14010138.
There is no consensus on the effect of red blood cell (RBC) transfusions on patients with oral squamous cell carcinoma (OSCC). The aim of this study was to investigate the association between RBC administration and the occurrence of distant metastases (M+) after surgical treatment of OSCC. All medical records of patients who underwent primary surgery for OSCC in our department (2003-2019) were analyzed retrospectively ( = 609). Chi and Cox regression models were used to analyze the influence of transfusion on the development of M+, and survival rates. Kaplan-Meier curves were used for graphical presentation. A multitude of patient-specific factors showed a statistical impact in univariate analysis (transfusion, age, gender, diabetes, pT, pN, L, V, Pn, G, UICC, adjuvant therapy, free microvascular transplant, preoperative hemoglobin level). Transfusion status and pN stage were the only variables that showed a significant correlation to M+ in the multivariate Cox model. The hazard ratios for the occurrence of M+ were 2.42 for RBC transfusions and 2.99 for pN+. Administration of RBC transfusions was identified as a significant prognostic parameter for the occurrence of distant metastases after surgical treatment of OSCC. Hence, the administration of RBC transfusions should be considered carefully in the perioperative management.
关于红细胞（RBC）输血对口腔鳞状细胞癌（OSCC）患者的影响，目前尚无共识。本研究的目的是调查RBC输注与OSCC手术治疗后远处转移（M+）发生之间的关联。回顾性分析了2003年至2019年在我科接受OSCC初次手术患者的所有病历（n = 609）。采用卡方检验和Cox回归模型分析输血对M+发生及生存率的影响。采用Kaplan-Meier曲线进行图形展示。众多患者特异性因素在单因素分析中显示出统计学影响（输血、年龄、性别、糖尿病、pT、pN、L、V、Pn、G、UICC、辅助治疗、游离微血管移植、术前血红蛋白水平）。在多因素Cox模型中，输血状态和pN分期是仅有的与M+显著相关的变量。RBC输血发生M+的风险比为2.42，pN+为2.99。RBC输血被确定为OSCC手术治疗后远处转移发生的一个重要预后参数。因此，在围手术期管理中应谨慎考虑RBC输血的应用。
