RESUMO
BACKGROUND: The association between perioperative blood transfusion and cancer prognosis in patients with head and neck cancer (HNC) receiving surgery remains controversial. METHODS: We designed a retrospective observational study of patients with HNC undergoing tumor resection surgery from 2014 to 2017 and followed them up until June 2020. An inverse probability of treatment weighting (IPTW) was applied to balance baseline patient characteristics in the exposed and unexposed groups. COX regression was used for the evaluation of tumor recurrence and overall survival. RESULTS: A total of 683 patients were included; 192 of them (28.1%) received perioperative packed RBC transfusion. Perioperative blood transfusion was significantly associated with HNC recurrence (IPTW adjusted HR: 1.37, 95% CI: 1.1-1.7, p = 0.006) and all-cause mortality (IPTW adjusted HR: 1.37, 95% CI: 1.07-1.74, p = 0.011). Otherwise, there was an increased association with cancer recurrence in a dose-dependent manner. CONCLUSION: Perioperative transfusion was associated with cancer recurrence and mortality after HNC tumor surgery.
RESUMO
Surgical resection remains the treatment of choice for mature mediastinal teratoma, and the operation itself is sometimes complicated or life-threatening, especially when it ruptures into adjacent vital structures. We describe a rare case of unanticipatedly delayed complete resection of a symptomatic teratoma with simultaneous Haemophilus influenzae infection, followed by extended rupture into the pleural space, lung, and bronchus. The clinical presentation and the microbiological and radiologic features may lead to the impression of a lung abscess until it can be proven otherwise pathologically after an initial thoracic aspiration. Accordingly, surgical intervention through a minimal approach, such as video-assisted thoracoscopic surgery, might be considered a strategy after the initial extended rupture.