title: Negative impact of fresh-frozen plasma transfusion on prognosis after hepatic resection for liver metastases from colorectal cancer.
abstract: BACKGROUND
  In perioperative management of hepatic resection for colorectal cancer liver metastasis (CRLM), excessive blood loss and blood transfusion greatly influence postoperative complications and prognosis of the patients. We evaluated the influence of the use of blood products on prognosis of patients with CRLM.
  
  
  METHODS
  The subjects of this study were 65 patients who underwent elective hepatic resection between January 2001 and April 2011 for CRLM without distant metastasis or other malignancy. We retrospectively investigated the influence of the use of blood products, including red cell concentrate (RC) and fresh frozen plasma (FFP), and clinical variables on overall survival.
  
  
  RESULTS
  In univariate analysis, bilobar distribution (p=0.0332), more than four lymph node metastases of the primary cancer (p=0.0155), perioperative RC use (p=0.0205), and perioperative FFP use (p=0.0065) were positively associated with poor overall survival rate. In multivariate analysis, bilobar distribution (p=0.0012), more than four lymph node metastases of the primary cancer (p=0.0171), and perioperative FFP use (p=0.0091), were independent risk factors for poor overall survival rate.
  
  
  CONCLUSIONS
  The use of FFP is associated with worse overall survival after elective hepatic resection for patients with CRLM.
authors.affiliation: Department of Surgery, School of Medicine, Jikei University, Minato-ku, Tokyo, Japan. hs0817@jikei.ac.jp
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Shiba
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Ishida
authors.forename: Koichiro
authors.initials: K
authors.lastname: Haruki
authors.forename: Kenei
authors.initials: K
authors.lastname: Furukawa
authors.forename: Yuki
authors.initials: Y
authors.lastname: Fujiwara
authors.forename: Ryota
authors.initials: R
authors.lastname: Iwase
authors.forename: Masahisa
authors.initials: M
authors.lastname: Ohkuma
authors.forename: Masaichi
authors.initials: M
authors.lastname: Ogawa
authors.forename: Takeyuki
authors.initials: T
authors.lastname: Misawa
authors.forename: Katsuhiko
authors.initials: K
authors.lastname: Yanaga
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016913:Blood Component Transfusion; D015179:Colorectal Neoplasms / Q000473:pathology*; D018572:Disease-Free Survival; D005260:Female; D006498:Hepatectomy / Q000009:adverse effects; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary* / Q000601:surgery*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D010949:Plasma; D011183:Postoperative Complications; D019106:Postoperative Hemorrhage; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate
keywords: Blood transfusion; colorectal cancer; hepatic resection; liver metastasis; prognosis