Perioperative blood transfusion is associated with poor long-term survival among patients with pancreatic adenocarcinoma

Abstract

Background: Perioperative red blood cell transfusion (RBCT) can negatively affect the host’s immune system. This study investigated the effects of perioperative RBCT on long-term survival among patients with pancreatic ductal adenocarcinoma (PDAC). Methods: We retrospectively evaluated 148 patients with PDAC who underwent surgery with curative intent (33 patients received RBCTs and 115 patients did not receive RBCTs). Significant prognostic variables in the univariate analyses were subjected to multivariate analyses using a Cox proportional hazard regression model. We also adjusted for different covariate distributions in each group using inverse probability of treatment weighting, and the prognostic variables were re-analyzed. Results: Patients received and did not receive RBCT exhibited significant differences in age, preoperative hemoglobin levels, CA19-9 levels, maximum tumor size, tumor staging, operative time, intraoperative blood loss, major vascular resection, and the proportion of pancreaticoduodenectomy. In the unweighted analyses, patients with RBCT exhibited significantly poorer overall survival (P < 0.001) and recurrence-free survival (P < 0.001), compared to patients without RBCT. After adjusting for the different covariates, perioperative RBCT remained an independent risk factor for poorer long-term overall and recurrence-free survivals. Conclusion: Perioperative RBCT was associated with poorer long-term survival rates among patients with PDAC who underwent surgery with curative intent.