title: Investigating the association between perioperative blood transfusions and outcomes in children undergoing cytoreductive surgery with hyperthermic intraperitoneal chemotherapy.
abstract: OBJECTIVE
  Studies indicate the perioperative transfusion of red blood cells during oncologic surgery may be associated with worse outcomes. In this study, we evaluated the impact of red blood cell transfusions on the short- and long-term outcomes of children undergoing a major oncologic surgery.
  
  
  METHODS
  A retrospective review of the medical records of children ≤18 years of age who had undergone cytoreductive surgery with hyperthermic intraperitoneal chemotherapy was performed. Univariate and multivariate analyses were performed to identify factors influencing survival, complications and length of stay.
  
  
  RESULTS
  Seventy-five children were identified, 80% of whom had received a red blood cell transfusion. Children who received a red blood cell transfusion had a significantly longer length of stay (P = 0·0003). However, the association between red blood cell transfusions and recurrence-free survival (HR: 1·307, 95% CI: 0·547-3·124; P = 0·55), overall survival (HR: 1·487, 95% CI: 0·585-3·780; P = 0·40) or the incidence of major complications (27·8 vs. 0% in non-transfused children, P = 0·18) was not statistically significant.
  
  
  CONCLUSIONS
  This retrospective study of children undergoing major oncologic surgery did not demonstrate a significant association between red blood cell transfusions and worse outcomes.
authors.affiliation: Department of Anesthesiology and Perioperative Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: P
authors.initials: P
authors.lastname: Owusu-Agyemang
authors.affiliation: Department of Anesthesiology and Perioperative Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: U U
authors.initials: UU
authors.lastname: Williams
authors.affiliation: Department of Anesthesiology and Perioperative Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: A
authors.initials: A
authors.lastname: Van Meter
authors.affiliation: Department of Anesthesiology and Perioperative Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: A M
authors.initials: AM
authors.lastname: Zavala
authors.affiliation: Department of Anesthesiology and Perioperative Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: E
authors.initials: E
authors.lastname: Rebello
authors.affiliation: Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: L
authors.initials: L
authors.lastname: Feng
authors.affiliation: Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: A
authors.initials: A
authors.lastname: Hayes-Jordan
authors.affiliation: Department of Anesthesiology and Perioperative Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.|Department of Anesthesiology and Surgical Oncology Research Group, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: J P
authors.initials: JP
authors.lastname: Cata
mesh_terms: D000293:Adolescent; D000970:Antineoplastic Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D065426:Cytoreduction Surgical Procedures; D018572:Disease-Free Survival; D017707:Erythrocyte Transfusion; D005260:Female; D006801:Humans; D007223:Infant; D053208:Kaplan-Meier Estimate; D007902:Length of Stay; D008297:Male; D015999:Multivariate Analysis; D020360:Neoadjuvant Therapy; D009369:Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents
keywords: blood transfusion; children; outcomes