title: The association between allogeneic perioperative blood transfusion on tumour recurrence and survival in patients with advanced ovarian cancer.
abstract: OBJECTIVE
  To evaluate the association between perioperative blood transfusion on the recurrence and survival of patient with advanced ovarian cancer.
  
  
  BACKGROUND
  Cytoreductive surgery for ovarian cancer can be an extensive procedure often requiring allogeneic blood transfusions. Blood transfusions can have detrimental effects on immune function which can lead to a decrease in the organism ability to detect and destroy metastasis.
  
  
  METHODS
  The study was a retrospective cohort investigation. Patients with advanced ovarian cancer (stage III) undergoing cytoreductive surgery were stratified by the need for perioperative blood transfusion. Allogeneic transfusions were non-leucodepleted. Primary outcome included time to recurrence and survival. Data were extracted from the gynaecology oncology database at Northwestern University. Times to event outcomes were evaluated by constructing Kaplan-Meyer curves and Cox regression.
  
  
  RESULTS
  The charts of 136 subjects were evaluated. Seventy-six received blood transfusion. Median [95% confidence interval (CI)] time to recurrence for the non-transfusion group was longer, i.e. 17 (6-27) months, compared to 11 (8-14) months for the transfused group (P = 0.03). Median (95% CI) survival following surgery was longer in the non-transfused group, i.e. 58 (43-73) months, compared to 36 (28-44) months for the transfused group (P = 0.04). Cox regression showed that transfused subjects had shorter median times to recurrence and mortality after adjusting for age and tumour grade.
  
  
  CONCLUSIONS
  There is an association between ovarian cancer recurrence and allogeneic perioperative blood transfusion in patients with advanced ovarian cancer undergoing cytoreductive surgery. These findings may have important implications in the perioperative management of those patients.
authors.affiliation: Department of Anesthesiology, Northwestern University, Chicago, Illinois 60611, USA. g-jr@northwestern.edu
authors.forename: G S
authors.initials: GS
authors.lastname: De Oliveira
authors.forename: J C
authors.initials: JC
authors.lastname: Schink
authors.forename: C
authors.initials: C
authors.lastname: Buoy
authors.forename: S
authors.initials: S
authors.lastname: Ahmad
authors.forename: P C
authors.initials: PC
authors.lastname: Fitzgerald
authors.forename: R J
authors.initials: RJ
authors.lastname: McCarthy
mesh_terms: D000368:Aged; D001803:Blood Transfusion; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D019990:Perioperative Care; D012189:Retrospective Studies; D015996:Survival Rate