The effect of transfusion on survival in head and neck cancer after free tissue reconstruction
Abstract Objective To examine if perioperative blood transfusion affects overall survival (OS) and recurrence‐free survival (RFS) in head and neck cancer patients who undergo free tissue reconstruction. Design Retrospective cohort study. Methods The medical records of free tissue flaps between 2007...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2024-02-01
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| Series: | Laryngoscope Investigative Otolaryngology |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/lio2.1215 |
| _version_ | 1797299327460179968 |
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| author | Yash J. Patil Mohamed Yakoub Kattia F. Moreno Colin Cotton Meredith E. Tabangin Mekibib Altaye Reena Dhanda Patil Alice Tang Chad Zender Aaron Domack |
| author_facet | Yash J. Patil Mohamed Yakoub Kattia F. Moreno Colin Cotton Meredith E. Tabangin Mekibib Altaye Reena Dhanda Patil Alice Tang Chad Zender Aaron Domack |
| author_sort | Yash J. Patil |
| collection | DOAJ |
| description | Abstract Objective To examine if perioperative blood transfusion affects overall survival (OS) and recurrence‐free survival (RFS) in head and neck cancer patients who undergo free tissue reconstruction. Design Retrospective cohort study. Methods The medical records of free tissue flaps between 2007 and 2010 were reviewed. Differences in demographics and clinical factors based on the level of transfused packed red blood cells (PRBC) were examined using chi‐squared tests, Kruskal–Wallis tests, and/or ANOVA tests. Survival time was compared using a Cox proportional hazard model. Results Data were available for 183 patients. Patients who had PRBC transfusion significantly differed from the non‐transfused group by flap type, flap with bone, Charlson Comorbidity Index (CCI), and hemoglobin and hematocrit. When stratified into three groups based on units of PRBC; flap type, flap with bone, CCI, preoperative hemoglobin, and hematocrit were found to differ significantly. The 2‐year Kaplan–Meier plot demonstrated improved OS for those who did not receive any PRBC transfusion. The use of more than 3 units of blood decreased 2‐year OS significantly when compared to the non‐transfused group. Finally, after adjusting for CCI using a Cox proportional hazard model, survival was significantly affected by CCI. Conclusion After controlling for patient age, oncologic stage, cancer subsite, histology, type of free flap, vascularized bone‐containing flap, recurrence type, CCI, and preoperative hemoglobin and hematocrit, patients who received 3 or more units of PRBC in the perioperative period had significantly decreased OS. RFS did not differ between the transfused versus non‐transfused groups. Level of Evidence Level 4. |
| first_indexed | 2024-03-07T22:49:00Z |
| format | Article |
| id | doaj.art-ea20ac9337c847b79f7df401004f1a66 |
| institution | Directory Open Access Journal |
| issn | 2378-8038 |
| language | English |
| last_indexed | 2024-03-07T22:49:00Z |
| publishDate | 2024-02-01 |
| publisher | Wiley |
| record_format | Article |
| series | Laryngoscope Investigative Otolaryngology |
| spelling | doaj.art-ea20ac9337c847b79f7df401004f1a662024-02-23T12:00:37ZengWileyLaryngoscope Investigative Otolaryngology2378-80382024-02-0191n/an/a10.1002/lio2.1215The effect of transfusion on survival in head and neck cancer after free tissue reconstructionYash J. Patil0Mohamed Yakoub1Kattia F. Moreno2Colin Cotton3Meredith E. Tabangin4Mekibib Altaye5Reena Dhanda Patil6Alice Tang7Chad Zender8Aaron Domack9Department of Otolaryngology Head and Neck Surgery University of Cincinnati Medical Center Cincinnati Ohio USADepartment of Pathology and Laboratory Medicine University of Cincinnati Medical Center Cincinnati Ohio USADepartment of Otolaryngology Head and Neck Surgery University of Cincinnati Medical Center Cincinnati Ohio USAUniversity of Cincinnati College of Medicine Cincinnati Ohio USADivision of Biostatistics and Epidemiology Cincinnati Children's Hospital Medical Center Cincinnati Ohio USADivision of Biostatistics and Epidemiology Cincinnati Children's Hospital Medical Center Cincinnati Ohio USADepartment of Otolaryngology Head and Neck Surgery University of Cincinnati Medical Center Cincinnati Ohio USADepartment of Otolaryngology Head and Neck Surgery University of Cincinnati Medical Center Cincinnati Ohio USADepartment of Otolaryngology Head and Neck Surgery University of Cincinnati Medical Center Cincinnati Ohio USAHead and Neck Department AdventHealth Orlando Florida USAAbstract Objective To examine if perioperative blood transfusion affects overall survival (OS) and recurrence‐free survival (RFS) in head and neck cancer patients who undergo free tissue reconstruction. Design Retrospective cohort study. Methods The medical records of free tissue flaps between 2007 and 2010 were reviewed. Differences in demographics and clinical factors based on the level of transfused packed red blood cells (PRBC) were examined using chi‐squared tests, Kruskal–Wallis tests, and/or ANOVA tests. Survival time was compared using a Cox proportional hazard model. Results Data were available for 183 patients. Patients who had PRBC transfusion significantly differed from the non‐transfused group by flap type, flap with bone, Charlson Comorbidity Index (CCI), and hemoglobin and hematocrit. When stratified into three groups based on units of PRBC; flap type, flap with bone, CCI, preoperative hemoglobin, and hematocrit were found to differ significantly. The 2‐year Kaplan–Meier plot demonstrated improved OS for those who did not receive any PRBC transfusion. The use of more than 3 units of blood decreased 2‐year OS significantly when compared to the non‐transfused group. Finally, after adjusting for CCI using a Cox proportional hazard model, survival was significantly affected by CCI. Conclusion After controlling for patient age, oncologic stage, cancer subsite, histology, type of free flap, vascularized bone‐containing flap, recurrence type, CCI, and preoperative hemoglobin and hematocrit, patients who received 3 or more units of PRBC in the perioperative period had significantly decreased OS. RFS did not differ between the transfused versus non‐transfused groups. Level of Evidence Level 4.https://doi.org/10.1002/lio2.1215blood transfusionfree flapfree tissue transferhead and neck cancer |
| spellingShingle | Yash J. Patil Mohamed Yakoub Kattia F. Moreno Colin Cotton Meredith E. Tabangin Mekibib Altaye Reena Dhanda Patil Alice Tang Chad Zender Aaron Domack The effect of transfusion on survival in head and neck cancer after free tissue reconstruction Laryngoscope Investigative Otolaryngology blood transfusion free flap free tissue transfer head and neck cancer |
| title | The effect of transfusion on survival in head and neck cancer after free tissue reconstruction |
| title_full | The effect of transfusion on survival in head and neck cancer after free tissue reconstruction |
| title_fullStr | The effect of transfusion on survival in head and neck cancer after free tissue reconstruction |
| title_full_unstemmed | The effect of transfusion on survival in head and neck cancer after free tissue reconstruction |
| title_short | The effect of transfusion on survival in head and neck cancer after free tissue reconstruction |
| title_sort | effect of transfusion on survival in head and neck cancer after free tissue reconstruction |
| topic | blood transfusion free flap free tissue transfer head and neck cancer |
| url | https://doi.org/10.1002/lio2.1215 |
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