Annals of Surgical Oncology

, Volume 22, Issue 13, pp 4382–4391 | Cite as

Perioperative Blood Transfusion and the Prognosis of Pancreatic Cancer Surgery: Systematic Review and Meta-analysis

  • Michael N. Mavros
  • Li Xu
  • Hadia Maqsood
  • Faiz Gani
  • Aslam Ejaz
  • Gaya Spolverato
  • Waddah B. Al-Refaie
  • Steven M. Frank
  • Timothy M. PawlikEmail author
Pancreatic Tumors



Perioperative blood transfusion (PBT) is common in pancreatic surgery. Recent studies have suggested that PBT may be associated with worse long-term outcomes.


A systematic review and meta-analysis of studies comparing long-term clinical outcomes of cancer patients undergoing curative-intent pancreatic surgery with regard to occurrence of PBT was performed.


A total of 23 studies (4339 patients) were included in the systematic review, and 19 studies (3646 patients) were included in the meta-analysis. Nearly half (45.8 %) of all patients were female (range 25–60 %), and median age ranged from 59 to 72 years. About half (46.5 %, range 19–72 %) of the patients were transfused. Most had pancreatic ductal adenocarcinoma (69.5 %), while others had ampullary carcinoma (15.0 %), cholangiocarcinoma (7.4 %), or exocrine tumors of pancreas (8.1 %). Most (91.1 %) underwent pancreaticoduodenectomy, while the remaining patients underwent a total or distal pancreatectomy. The 5-year overall survival for all patients ranged from 0 to 65 %. Thirteen and nine of 19 studies reported a detrimental effect of PBT on survival on univariable and multivariable analysis, respectively. Overall, PBT was associated with shorter overall survival (pooled odds ratio 2.43, 95 % confidence interval 1.90–3.10); this finding was reproduced in sensitivity analysis.


Patients receiving PBT had significantly lower 5-year survival after curative-intent pancreatic surgery. Further research should focus on implementing guidelines for and discerning factors associated with the poor outcomes after PBT.


Distal Pancreatectomy Pancreatic Ductal Adenocarcinoma Pancreatic Resection Ampullary Carcinoma Transfusion Practice 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.





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Copyright information

© Society of Surgical Oncology 2015

Authors and Affiliations

  • Michael N. Mavros
    • 1
    • 2
    • 3
  • Li Xu
    • 2
    • 4
    • 5
  • Hadia Maqsood
    • 2
  • Faiz Gani
    • 2
  • Aslam Ejaz
    • 6
  • Gaya Spolverato
    • 2
  • Waddah B. Al-Refaie
    • 7
  • Steven M. Frank
    • 8
  • Timothy M. Pawlik
    • 2
    Email author
  1. 1.Department of SurgeryMedStar Washington Hospital CenterWashingtonUSA
  2. 2.Department of SurgeryJohns Hopkins University School of MedicineBaltimoreUSA
  3. 3.Alfa Institute of Biomedical Sciences, MarousiAthensGreece
  4. 4.Department of Hepatobiliary SurgerySun Yat-sen University Cancer CenterGuangzhouChina
  5. 5.State Key Laboratory of Oncology in Southern ChinaGuangzhouChina
  6. 6.Department of SurgeryUniversity of Illinois Hospital and Health Sciences SystemChicagoUSA
  7. 7.Department of SurgeryMedStar Georgetown University Hospital CenterWashingtonUSA
  8. 8.Department of Anesthesiology and Critical Care MedicineJohns Hopkins University School of MedicineBaltimoreUSA

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