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The effect of transfusion on survival in head and neck cancer after free tissue reconstruction.
Patil, Yash J; Yakoub, Mohamed; Moreno, Kattia F; Cotton, Colin; Tabangin, Meredith E; Altaye, Mekibib; Patil, Reena Dhanda; Tang, Alice; Zender, Chad; Domack, Aaron.
Afiliação
  • Patil YJ; Department of Otolaryngology Head and Neck Surgery University of Cincinnati Medical Center Cincinnati Ohio USA.
  • Yakoub M; Department of Pathology and Laboratory Medicine University of Cincinnati Medical Center Cincinnati Ohio USA.
  • Moreno KF; Department of Otolaryngology Head and Neck Surgery University of Cincinnati Medical Center Cincinnati Ohio USA.
  • Cotton C; University of Cincinnati College of Medicine Cincinnati Ohio USA.
  • Tabangin ME; Division of Biostatistics and Epidemiology Cincinnati Children's Hospital Medical Center Cincinnati Ohio USA.
  • Altaye M; Division of Biostatistics and Epidemiology Cincinnati Children's Hospital Medical Center Cincinnati Ohio USA.
  • Patil RD; Department of Otolaryngology Head and Neck Surgery University of Cincinnati Medical Center Cincinnati Ohio USA.
  • Tang A; Department of Otolaryngology Head and Neck Surgery University of Cincinnati Medical Center Cincinnati Ohio USA.
  • Zender C; Department of Otolaryngology Head and Neck Surgery University of Cincinnati Medical Center Cincinnati Ohio USA.
  • Domack A; Head and Neck Department AdventHealth Orlando Florida USA.
Laryngoscope Investig Otolaryngol ; 9(1): e1215, 2024 Feb.
Article em En | MEDLINE | ID: mdl-38362201
ABSTRACT

Objective:

To examine if perioperative blood transfusion affects overall survival (OS) and recurrence-free survival (RFS) in head and neck cancer patients who undergo free tissue reconstruction.

Design:

Retrospective cohort study.

Methods:

The medical records of free tissue flaps between 2007 and 2010 were reviewed. Differences in demographics and clinical factors based on the level of transfused packed red blood cells (PRBC) were examined using chi-squared tests, Kruskal-Wallis tests, and/or ANOVA tests. Survival time was compared using a Cox proportional hazard model.

Results:

Data were available for 183 patients. Patients who had PRBC transfusion significantly differed from the non-transfused group by flap type, flap with bone, Charlson Comorbidity Index (CCI), and hemoglobin and hematocrit. When stratified into three groups based on units of PRBC; flap type, flap with bone, CCI, preoperative hemoglobin, and hematocrit were found to differ significantly. The 2-year Kaplan-Meier plot demonstrated improved OS for those who did not receive any PRBC transfusion. The use of more than 3 units of blood decreased 2-year OS significantly when compared to the non-transfused group. Finally, after adjusting for CCI using a Cox proportional hazard model, survival was significantly affected by CCI.

Conclusion:

After controlling for patient age, oncologic stage, cancer subsite, histology, type of free flap, vascularized bone-containing flap, recurrence type, CCI, and preoperative hemoglobin and hematocrit, patients who received 3 or more units of PRBC in the perioperative period had significantly decreased OS. RFS did not differ between the transfused versus non-transfused groups. Level of Evidence Level 4.
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Texto completo: 1 Base de dados: MEDLINE Tipo de estudo: Observational_studies / Prognostic_studies Idioma: En Revista: Laryngoscope Investig Otolaryngol Ano de publicação: 2024 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Tipo de estudo: Observational_studies / Prognostic_studies Idioma: En Revista: Laryngoscope Investig Otolaryngol Ano de publicação: 2024 Tipo de documento: Article