Neoadjuvant chemotherapy is associated with more anemia and perioperative blood transfusions than primary debulking surgery in women with advanced stage ovarian cancer.
Gynecol Oncol
; 150(1): 19-22, 2018 07.
Article
em En
| MEDLINE
| ID: mdl-29773300
ABSTRACT
OBJECTIVE:
The purpose of this case-controlled study was to determine the prevalence of anemia and incidence of perioperative blood transfusions in patients undergoing treatment for advanced ovarian cancer with neoadjuvant chemotherapy (NACT) or primary debulking surgery (PDS).METHODS:
We performed a single institution review of patients diagnosed with stage IIIB-IVB epithelial ovarian cancer between 2010 and 2013 undergoing either NACT or PDS. Anemia was defined as a hemoglobin (Hgb) concentration of ≤11.5â¯g/dL. Continuous variables were compared by student t-test and binary variables compared via chi square analysis.RESULTS:
One hundred thirty-one women were included, 66 treated with NACT and 65 treated with PDS. Average Hgb prior to surgery was lower in women who received NACT (10.7â¯g/dL vs 12.8â¯g/dL, pâ¯<â¯0.0001). Women treated with NACT had a decrease in mean Hgb during chemotherapy treatment (11.8â¯g/dL at diagnosis to 10.7â¯g/dL preoperatively). Seventy-seven percent of NACT patients were anemic prior to surgery compared to 15% of patients prior to PDS (pâ¯<â¯0.001). Mean EBL at debulking was higher in patients selected for PDS (871â¯mL) than NACT (544â¯mL); however, the perioperative transfusion rate was higher during interval debulking surgeries (NACT 77% vs PDS 56%, pâ¯=â¯0.01).CONCLUSION:
Women selected for NACT were more likely to be anemic at diagnosis and became progressively anemic during NACT. Despite less blood loss during debulking surgery, NACT patients receive more blood transfusions perioperatively than patients undergoing PDS. This represents a potential opportunity for therapeutic intervention during NACT to correct anemia prior to interval debulking surgery.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Neoplasias Ovarianas
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Transfusão de Sangue
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Quimioterapia Adjuvante
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Procedimentos Cirúrgicos de Citorredução
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Anemia
Tipo de estudo:
Observational_studies
/
Risk_factors_studies
Limite:
Aged
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Female
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Humans
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Middle aged
Idioma:
En
Revista:
Gynecol Oncol
Ano de publicação:
2018
Tipo de documento:
Article
País de afiliação:
Estados Unidos