Abstract

Many dietary supplements, including omega-3 fatty acids (ω3), are suspected to affect blood coagulation and platelet function. Despite no clinical evidence, discontinuation is recommended before radical prostatectomy. However, long-chain ω3 (LCω3) appear beneficial against prostate cancer progression. Here, we aim to determine the effect of LCω3 supplements on perioperative bleeding, hemoglobin, platelets, and postoperative complications after radical prostatectomy. This is a planned exploratory analysis of 130 patients diagnosed with prostate cancer grade group 2 or greater enrolled in a randomized controlled trial (NCT02333435) testing the effects of LCω3, on prostate cancer biological and pathological outcomes at radical prostatectomy as main outcomes. The LCω3 intervention (MAG-EPA 3g daily) or equivalent placebo was given 4-10 weeks prior to radical prostatectomy. An intention-to-treat analysis approach was used with bi-variate statistical testing of bleeding and complications outcomes. We also estimated the difference between groups using linear regression and non-parametric quantile regression models. All models were adjusted for confounding variables selected on clinical relevance. We found no clinically significant effect of LCω3 versus placebo on perioperative bleeding, laboratory tests or postoperative complications. In contrast, as expected, we found a significant increase in perioperative bleeding in open retropubic radical prostatectomy compared to robot-assisted radical prostatectomy (adjusted difference 115.8mL, p=0.04). Our results suggest that ω3 supplements can be safely taken before radical prostatectomy without increasing surgical bleeding risk. These findings are relevant since ω3 may beneficially affect prostate cancer evolution.

Highlights

  • Many commonly used dietary supplements, including omega-3 fatty acids (u3) contained in fish oil, have been suspected to affect blood coagulation and platelet function [1]

  • Our results suggest that long-chain u3 (LCu3) supplements can be safely taken before radical prostatectomy intervention without increasing the risk of surgical bleeding or post-operative complications

  • As expected, we found a significant increase in perioperative bleeding in open retropubic radical prostatectomy compared to robot-assisted radical prostatectomy

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Summary

Introduction

Many commonly used dietary supplements, including omega-3 fatty acids (u3) contained in fish oil, have been suspected to affect blood coagulation and platelet function [1]. For u3, concerns over theoretical bleeding risk that may be caused by changes in platelet function, have led to prohibiting these supplements before surgery, even if little or no clinical evidence supports this practice [5e7]. Singbo et al. Many dietary supplements, including omega-3 fatty acids (u3), are suspected to affect blood coagulation and platelet function. We aim to determine the effect of LCu3 supplements on perioperative bleeding, hemoglobin, platelets, and postoperative complications after radical prostatectomy. Methods: This is a planned exploratory analysis of 130 patients diagnosed with prostate cancer grade group 2 or greater enrolled in a randomized controlled trial (NCT02333435) testing the effects of LCu3, on prostate cancer biological and pathological outcomes at radical prostatectomy as main outcomes.

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