The Effect of Perioperative Blood Transfusion on Long-Term Survival Outcomes After Surgery for Pancreatic Ductal Adenocarcinoma: A Systematic Review.

Pancreas
Linda YeO Joe Hines

Abstract

To evaluate survival outcomes associated with perioperative allogeneic red blood cell transfusion (RBCT) in patients with pancreatic ductal adenocarcinoma undergoing surgery. PubMed, Embase, Cochrane, and Web of Science Core Collection were queried for English-language articles until May 28, 2020. Studies evaluating long-term outcomes of RBCT compared with no transfusion in adults with pancreatic ductal adenocarcinoma undergoing pancreatectomy were included. E-value sensitivity analysis assessed the potential for unmeasured confounders to overcome these findings. Of 4379 citations, 5 retrospective cohort studies were included. Three studies reported shorter recurrence-free survival by 1 to 5 months with RBCT. Two studies found shorter disease-specific survival by 5 to 13 months with RBCT. Overall survival was reduced by 5 to 7 months with RBCT in 3 studies. All multivariable findings associated with RBCT could be readily overcome unmeasured confounding on sensitivity analysis. Confounding in baseline characteristics resulted in high risk of bias. Imprecision, unmeasured confounding, small effect sizes, and overall low quality of the available literature result in uncertainty regarding the effect of transfusion on recurrence-fre...Continue Reading

References

Oct 1, 1984·Archives of Surgery·R S FosterM C Costanza
Jul 22, 2009·PLoS Medicine·David MoherUNKNOWN PRISMA Group
Aug 27, 2013·Surgery·Amelia RossWilliam E Fisher
Dec 11, 2013·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Donald J LucasTimothy M Pawlik
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Dec 31, 2014·Pancreatology : Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]·Manuel HidalgoVolker Heinemann
Jul 12, 2017·Annals of Internal Medicine·Tyler J VanderWeele, Peng Ding
Jan 25, 2019·JAMA : the Journal of the American Medical Association·Sebastien HaneuseDavid Arterburn

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