Perioperative blood transfusions and survival in resected pancreatic adenocarcinoma patients given multimodality therapy

Timothy E. Newhook; Laura R. Prakash; Jose Soliz; Shannon Hancher-Hodges; B. Bryce Speer; Jonathan A. Wilks; Morgan L. Bruno; Whitney L. Dewhurst; Elsa M. Arvide; Jessica E. Maxwell; Naruhiko Ikoma; Michael P. Kim; Jeffrey E. Lee; Matthew H.G. Katz; Ching Wei D. Tzeng

doi:10.1002/jso.26650

Perioperative blood transfusions and survival in resected pancreatic adenocarcinoma patients given multimodality therapy

Timothy E. Newhook, Laura R. Prakash, Jose Soliz, Shannon Hancher-Hodges, B. Bryce Speer, Jonathan A. Wilks, Morgan L. Bruno, Whitney L. Dewhurst, Elsa M. Arvide, Jessica E. Maxwell, Naruhiko Ikoma, Michael P. Kim, Jeffrey E. Lee, Matthew H.G. Katz, Ching Wei D. Tzeng

Research output: Contribution to journal › Article › peer-review

3 Scopus citations

Abstract

Background and Objectives: The impact of perioperative blood transfusion (PBT) on outcomes for pancreatic ductal adenocarcinoma (PDAC) patients given multimodality therapy (MMT) remains undefined. We sought to evaluate the association of PBT with survival after PDAC resection. Methods: Pancreatectomy patients (July 2011–December 2017) who received MMT were abstracted from a prospective database. Overall survival (OS) was compared by PBT within 30 days, 24 h (24HR-BT), or 24 h until 30 days (Postop-BT). Results: Most (76.6%) of 312 MMT patients underwent neoadjuvant therapy (NT). Eighty-nine patients (28.5%) received PBT; 58 (18.6%) 24HR-BT, and 31 (9.9%) Postop-BT. Compared with surgery-first, NT patients received more 24HR-BTs (22.2% vs. 6.8%, p = 0.003) and PBTs overall (32.6% vs. 15.1%, p = 0.004). Overall median OS was 45 months. The association of PBT with shorter median OS appeared limited to first 24-h transfusions (34 months 24HR-BT vs. 48 months Postop-BT vs. 53 months no-PBT, p = 0.009) and was dose-dependent, with a median OS of 52 months for 0 units 24HR-BT, 35 months for 1 unit, and 25 months for ≥2 units (p = 0.004). Independent predictors of OS included node-positivity (hazard ratio [HR]: 1.93, p < 0.001), perineural invasion (HR: 1.64, p = 0.050), postoperative pancreatic fistula (HR: 1.94, p = 0.018), and 24HR-BT (HR: 1.75, p = 0.001). Conclusions: Transfusions given within 24 h are associated with dose-dependent decreases in survival after pancreatectomy for PDAC.

Original language	English (US)
Pages (from-to)	1381-1389
Number of pages	9
Journal	Journal of surgical oncology
Volume	124
Issue number	8
DOIs	https://doi.org/10.1002/jso.26650
State	Published - Dec 15 2021

Keywords

blood transfusion
multimodality therapy
neoadjuvant therapy
pancreatic cancer
perioperative transfusion

ASJC Scopus subject areas

Surgery
Oncology

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10.1002/jso.26650

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Newhook, T. E., Prakash, L. R., Soliz, J., Hancher-Hodges, S., Speer, B. B., Wilks, J. A., Bruno, M. L., Dewhurst, W. L., Arvide, E. M., Maxwell, J. E., Ikoma, N., Kim, M. P., Lee, J. E., Katz, M. H. G., & Tzeng, C. W. D. (2021). Perioperative blood transfusions and survival in resected pancreatic adenocarcinoma patients given multimodality therapy. Journal of surgical oncology, 124(8), 1381-1389. https://doi.org/10.1002/jso.26650

Newhook, TE , Prakash, LR , Soliz, J , Hancher-Hodges, S , Speer, BB , Wilks, JA, Bruno, ML, Dewhurst, WL, Arvide, EM, Maxwell, JE , Ikoma, N , Kim, MP , Lee, JE , Katz, MHG & Tzeng, CWD 2021, 'Perioperative blood transfusions and survival in resected pancreatic adenocarcinoma patients given multimodality therapy', Journal of surgical oncology, vol. 124, no. 8, pp. 1381-1389. https://doi.org/10.1002/jso.26650

@article{34d072a5acdb4cb1852d4e759cfa0e87,

title = "Perioperative blood transfusions and survival in resected pancreatic adenocarcinoma patients given multimodality therapy",

abstract = "Background and Objectives: The impact of perioperative blood transfusion (PBT) on outcomes for pancreatic ductal adenocarcinoma (PDAC) patients given multimodality therapy (MMT) remains undefined. We sought to evaluate the association of PBT with survival after PDAC resection. Methods: Pancreatectomy patients (July 2011–December 2017) who received MMT were abstracted from a prospective database. Overall survival (OS) was compared by PBT within 30 days, 24 h (24HR-BT), or 24 h until 30 days (Postop-BT). Results: Most (76.6%) of 312 MMT patients underwent neoadjuvant therapy (NT). Eighty-nine patients (28.5%) received PBT; 58 (18.6%) 24HR-BT, and 31 (9.9%) Postop-BT. Compared with surgery-first, NT patients received more 24HR-BTs (22.2% vs. 6.8%, p = 0.003) and PBTs overall (32.6% vs. 15.1%, p = 0.004). Overall median OS was 45 months. The association of PBT with shorter median OS appeared limited to first 24-h transfusions (34 months 24HR-BT vs. 48 months Postop-BT vs. 53 months no-PBT, p = 0.009) and was dose-dependent, with a median OS of 52 months for 0 units 24HR-BT, 35 months for 1 unit, and 25 months for ≥2 units (p = 0.004). Independent predictors of OS included node-positivity (hazard ratio [HR]: 1.93, p < 0.001), perineural invasion (HR: 1.64, p = 0.050), postoperative pancreatic fistula (HR: 1.94, p = 0.018), and 24HR-BT (HR: 1.75, p = 0.001). Conclusions: Transfusions given within 24 h are associated with dose-dependent decreases in survival after pancreatectomy for PDAC.",

keywords = "blood transfusion, multimodality therapy, neoadjuvant therapy, pancreatic cancer, perioperative transfusion",

author = "Newhook, {Timothy E.} and Prakash, {Laura R.} and Jose Soliz and Shannon Hancher-Hodges and Speer, {B. Bryce} and Wilks, {Jonathan A.} and Bruno, {Morgan L.} and Dewhurst, {Whitney L.} and Arvide, {Elsa M.} and Maxwell, {Jessica E.} and Naruhiko Ikoma and Kim, {Michael P.} and Lee, {Jeffrey E.} and Katz, {Matthew H.G.} and Tzeng, {Ching Wei D.}",

note = "Funding Information: The authors thank Sarah Bronson, ELS, Research Medical Library, The University of Texas MD Anderson Cancer Center, for editing the manuscript. Publisher Copyright: {\textcopyright} 2021 Wiley Periodicals LLC",

year = "2021",

month = dec,

day = "15",

doi = "10.1002/jso.26650",

language = "English (US)",

volume = "124",

pages = "1381--1389",

journal = "Journal of surgical oncology",

issn = "0022-4790",

publisher = "Wiley-Liss Inc.",

number = "8",

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TY - JOUR

T1 - Perioperative blood transfusions and survival in resected pancreatic adenocarcinoma patients given multimodality therapy

AU - Newhook, Timothy E.

AU - Prakash, Laura R.

AU - Soliz, Jose

AU - Hancher-Hodges, Shannon

AU - Speer, B. Bryce

AU - Wilks, Jonathan A.

AU - Bruno, Morgan L.

AU - Dewhurst, Whitney L.

AU - Arvide, Elsa M.

AU - Maxwell, Jessica E.

AU - Ikoma, Naruhiko

AU - Kim, Michael P.

AU - Lee, Jeffrey E.

AU - Katz, Matthew H.G.

AU - Tzeng, Ching Wei D.

N1 - Funding Information: The authors thank Sarah Bronson, ELS, Research Medical Library, The University of Texas MD Anderson Cancer Center, for editing the manuscript. Publisher Copyright: © 2021 Wiley Periodicals LLC

PY - 2021/12/15

Y1 - 2021/12/15

N2 - Background and Objectives: The impact of perioperative blood transfusion (PBT) on outcomes for pancreatic ductal adenocarcinoma (PDAC) patients given multimodality therapy (MMT) remains undefined. We sought to evaluate the association of PBT with survival after PDAC resection. Methods: Pancreatectomy patients (July 2011–December 2017) who received MMT were abstracted from a prospective database. Overall survival (OS) was compared by PBT within 30 days, 24 h (24HR-BT), or 24 h until 30 days (Postop-BT). Results: Most (76.6%) of 312 MMT patients underwent neoadjuvant therapy (NT). Eighty-nine patients (28.5%) received PBT; 58 (18.6%) 24HR-BT, and 31 (9.9%) Postop-BT. Compared with surgery-first, NT patients received more 24HR-BTs (22.2% vs. 6.8%, p = 0.003) and PBTs overall (32.6% vs. 15.1%, p = 0.004). Overall median OS was 45 months. The association of PBT with shorter median OS appeared limited to first 24-h transfusions (34 months 24HR-BT vs. 48 months Postop-BT vs. 53 months no-PBT, p = 0.009) and was dose-dependent, with a median OS of 52 months for 0 units 24HR-BT, 35 months for 1 unit, and 25 months for ≥2 units (p = 0.004). Independent predictors of OS included node-positivity (hazard ratio [HR]: 1.93, p < 0.001), perineural invasion (HR: 1.64, p = 0.050), postoperative pancreatic fistula (HR: 1.94, p = 0.018), and 24HR-BT (HR: 1.75, p = 0.001). Conclusions: Transfusions given within 24 h are associated with dose-dependent decreases in survival after pancreatectomy for PDAC.

AB - Background and Objectives: The impact of perioperative blood transfusion (PBT) on outcomes for pancreatic ductal adenocarcinoma (PDAC) patients given multimodality therapy (MMT) remains undefined. We sought to evaluate the association of PBT with survival after PDAC resection. Methods: Pancreatectomy patients (July 2011–December 2017) who received MMT were abstracted from a prospective database. Overall survival (OS) was compared by PBT within 30 days, 24 h (24HR-BT), or 24 h until 30 days (Postop-BT). Results: Most (76.6%) of 312 MMT patients underwent neoadjuvant therapy (NT). Eighty-nine patients (28.5%) received PBT; 58 (18.6%) 24HR-BT, and 31 (9.9%) Postop-BT. Compared with surgery-first, NT patients received more 24HR-BTs (22.2% vs. 6.8%, p = 0.003) and PBTs overall (32.6% vs. 15.1%, p = 0.004). Overall median OS was 45 months. The association of PBT with shorter median OS appeared limited to first 24-h transfusions (34 months 24HR-BT vs. 48 months Postop-BT vs. 53 months no-PBT, p = 0.009) and was dose-dependent, with a median OS of 52 months for 0 units 24HR-BT, 35 months for 1 unit, and 25 months for ≥2 units (p = 0.004). Independent predictors of OS included node-positivity (hazard ratio [HR]: 1.93, p < 0.001), perineural invasion (HR: 1.64, p = 0.050), postoperative pancreatic fistula (HR: 1.94, p = 0.018), and 24HR-BT (HR: 1.75, p = 0.001). Conclusions: Transfusions given within 24 h are associated with dose-dependent decreases in survival after pancreatectomy for PDAC.

KW - blood transfusion

KW - multimodality therapy

KW - neoadjuvant therapy

KW - pancreatic cancer

KW - perioperative transfusion

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DO - 10.1002/jso.26650

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AN - SCOPUS:85112418861

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SP - 1381

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JO - Journal of surgical oncology

JF - Journal of surgical oncology

IS - 8

ER -

Perioperative blood transfusions and survival in resected pancreatic adenocarcinoma patients given multimodality therapy

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