Background

Packed red blood cell (PRBC) transfusion has been associated with worse survival in multiple malignancies but its impact on pancreatic neuroendocrine tumors (PNETs) is unknown. The aim of this study was to determine the impact of PRBC transfusion on survival following PNET resection.

Methods

A retrospective cohort study of PNET patients was performed using the US Neuroendocrine Tumor Study Group database. Demographic and clinical factors were compared. Kaplan–Meier and log-rank analyses were performed. Factors associated with transfusion, overall (OS), recurrence-free (RFS) and progression-free survival (PFS) were assessed by logistic regression.

Results

Of 1129 patients with surgically resected PNETs, 156 (13.8%) received perioperative PRBC transfusion. Transfused patients had higher ASA Class, lower preoperative hemoglobin, larger tumors, more nodal involvement, and increased major complications (all p < 0.010). Transfused patients had worse median OS (116 vs 150 months, p < 0.001), worse RFS (83 vs 128 months, p < 0.01) in curatively resected (n = 1047), and worse PFS (11 vs 24 months, p = 0.110) in non-curatively resected (n = 82) patients. On multivariable analysis, transfusion was associated with worse OS (HR 1.80, p = 0.011) when controlling for TNM stage, tumor grade, final resection status, and pre-operative anemia.

Conclusion

PRBC transfusion is associated with worse survival for patients undergoing PNET resection.

中文翻译：

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围手术期输血对胰腺神经内分泌肿瘤患者生存的影响：美国神经内分泌研究组的分析。

背景

浓缩红细胞（PRBC）输注与多种恶性肿瘤的生存率较差有关，但其对胰腺神经内分泌肿瘤（PNET）的影响尚不清楚。本研究的目的是确定 PRBC 输注对 PNET 切除术后生存的影响。

方法

使用美国神经内分泌肿瘤研究组数据库对 PNET 患者进行回顾性队列研究。比较了人口统计学和临床​​因素。进行了 Kaplan-Meier 和对数秩分析。通过逻辑回归评估与输血、总生存期（OS）、无复发生存期（RFS）和无进展生存期（PFS）相关的因素。

结果

在 1129 名手术切除 PNET 的患者中，156 名 (13.8%) 接受了围手术期 PRBC 输注。输血患者的 ASA 等级较高、术前血红蛋白较低、肿瘤较大、淋巴结受累较多以及主要并发症增加（所有 p < 0.010）。输血患者的中位 OS 较差（116 个月 vs 150 个月，p < 0.001），根治性切除（n = 1047）中的 RFS 较差（83 vs 128 个月，p < 0.01），PFS 较差（11 个月 vs 24 个月，p = 0.110） ）在非治愈性切除（n = 82）患者中。在多变量分析中，在控制 TNM 分期、肿瘤分级、最终切除状态和术前贫血时，输血与较差的 OS 相关（HR 1.80，p = 0.011）。

结论

PRBC 输注与接受 PNET 切除的患者生存率较差相关。