Perioperative blood transfusion does not decrease survival after surgical treatment of spinal metastases

Abstract

The results of the present study support that perioperative blood transfusion of <5 units does not decrease survival in patients operated for spinal metastases. Transfusion of 1-2 units seems to be associated with increased 12-month survival. Future studies should assess if a liberal transfusion regime can be applied to this group of patients; thereby, prioritizing early postoperative mobilization.

Metastatic spine tumor surgery: does perioperative blood transfusion influence postoperative complications?

“…On the other hand, some studies have refuted that blood transfusion did not increase the incidence of postoperative complications or infections . In patients undergoing MSTS, there have been studies in current literature that have evaluated the impact of ABT on survival with no emphasis on postoperative complications . With this background, we performed a retrospective analysis of the data of patients undergoing surgery for spinal metastases to explicate the influence of perioperative ABT on the spectrum of postoperative complications and infections.…”

Perioperative blood transfusion: does it influence survival and cancer progression in metastatic spine tumor surgery?

“…To date, only two studies were identified in the literature in which survival was the only outcome measured in relation to blood transfusion in patients who underwent MSTS. Clausen and colleagues . retrospectively studied the survival of 170 patients with respect to blood transfusion, age, sex, preoperative Hb levels, Tokuhashi scores, and the number of instrumented levels.…”

“…Among these, it has been postulated that immune suppression results in cancer recurrence or progression . Blood transfusion has also been proposed as an indicator of an overall poor outcome regardless of cancer recurrence and reportedly is associated with a poor prognosis in terms of all‐cause and cancer‐related mortality . However, some studies have reported that blood transfusion did not compromise oncological outcomes like cancer recurrence or survival .…”

Are Allogeneic Blood Transfusions Associated With Decreased Survival After Surgery for Long-bone Metastatic Fractures?

“…Clausen et al [7] showed that perioperative allogeneic blood transfusion in patients with spine metastases was not associated with 3-month survival; they found an increased 12-month survival after 1 to 2 units of allogeneic blood transfusion compared with no transfusion (odds ratio, 2.6; 95% CI, 1.0-6.8; p = 0.049) [7]. Increased survival might be explained by a difference in indication for blood transfusion or anatomic site studied, or because of the few confounding factors taken into account (preoperative hemoglobin, age, sex, Tokuhashi score [survival prognostication score], and number of instrumented levels) [7].…”

“…Clausen et al [7] showed that perioperative allogeneic blood transfusion in patients with spine metastases was not associated with 3-month survival; they found an increased 12-month survival after 1 to 2 units of allogeneic blood transfusion compared with no transfusion (odds ratio, 2.6; 95% CI, 1.0-6.8; p = 0.049) [7]. Increased survival might be explained by a difference in indication for blood transfusion or anatomic site studied, or because of the few confounding factors taken into account (preoperative hemoglobin, age, sex, Tokuhashi score [survival prognostication score], and number of instrumented levels) [7]. Previous studies in visceral metastatic disease have shown a negative effect of perioperative blood transfusion on survival [14,16]: Katoh et al [14] found that perioperative transfusion was independently associated with worse survival after resection of stage IV (disseminated disease) colorectal cancer (n = 162) after accounting for clinical and treatment parameters; Margulis et al [16] reported that survival of patients undergoing cytoreductive nephrectomy for metastatic renal cell carcinoma also was negatively influenced by intraoperative blood transfusion.…”