Effect of perioperative allogeneic blood transfusion on the prognosis of patients with non-small cell lung cancer: A systematic review and meta-analysis_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

WU Peng ^1,2 , PANG Yao ² , WANG Wenhao ² , YANG Yi ^1,2 , WANG Zequan ² , WANG Kui ^1,2 ,  ZHU Zijiang ²

1. School of Clinical Medicine, Gansu University of Chinese Medicine, Lanzhou, 730000, P.R.China;
2. Department 2 of Thoracic Surgery, Gansu Provincial Hospital, Lanzhou, 730000, P.R.China;

Corresponding author：

ZHU Zijiang, Email: 18419510885@163.com

Keywords：

Non-small cell lung cancer; allogeneic blood transfusion; prognosis; systematic review/meta-analysis

DOI：

10.7507/1007-4848.202008018

Video：

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Objective To investigate the effect of perioperative allogeneic blood transfusion on the prognosis of patients with non-small cell lung cancer (NSCLC).Methods The databases including PubMed, The Cochrane Library, EMbase, CNKI, Wanfang Data, VIP and CBM were searched for literature about the effects of perioperative allogeneic blood transfusion on the prognosis of patients with NSCLC from the inception to May 2020. Two authors independently screened the literature, extracted and cross-checked data, and negotiated to resolve differences in opinions. Review Manager V5.3 (Cochrane Collaboration, Oxford, UK) software was used for data analysis.Results A total of 15 articles were included, including 5 897 patients. There were 1 649 patients in the trial group and 4 248 patients in the control group. The results of meta-analysis showed that the overall survival of the control group was significantly higher than that of the trial group (OR=0.58, 95%CI 0.47-0.70, P<0.000 01). The disease-free survival of the control group was significantly higher than that of the trial group (OR=0.43, 95%CI 0.36-0.52, P<0.000 01). The recurrence rate of the control group was significantly lower than that of the trial group (OR=1.85, 95%CI 1.34-2.55, P=0.000 2).Conclusion Perioperative allogeneic blood transfusion has adverse effects on the recurrence and survival of patients with NSCLC.

1.	Sakin A, Sahin S, Yasar N, et al. Prognostic impact of blood transfusion in patients with metastatic non-small cell lung cancer receiving chemotherapy. Lung Cancer, 2019, 133: 38-44.
2.	Arenberg D. Update on screening for lung cancer. Transl Lung Cancer Res, 2019, 8(Suppl 1): S77-S87.77-87.
3.	Morgensztern D, Ng SH, Gao F, et al. Trends in stage distribution for patients with non-small cell lung cancer: a national cancer database survey. J Thorac Oncol, 2010, 5(1): 29-33.
4.	Siegel R, Naishadham D, Jemal A. Cancer statistics, 2012. CA Cancer J Clin, Jan-Feb 2012, 62(1): 10-29.
5.	Beale E, Zhu J, Chan L, et al. Blood transfusion in critically injured patients: a prospective study. Injury, 2006, 37(5): 455-465.
6.	Cata JP, Wang H, Gottumukkala V, et al. Inflammatory response, immunosuppression, and cancer recurrence after perioperative blood transfusions. Br J Anaesth, 2013, 110(5): 690-701.
7.	Zuck TF, Thomson RA, Schreiber GB, et al. The Retrovirus Epidemiology Donor Study (REDS): rationale and methods. Transfusion, Nov-Dec 1995, 35(11): 944-951.
8.	Opelz G, Sengar DP, Mickey MR, et al. Effect of blood transfusions on subsequent kidney transplants. Transplant Proc, 1973, 5(1): 253-259.
9.	Opelz G, Vanrenterghem Y, Kirste G, et al. Prospective evaluation of pretransplant blood transfusions in cadaver kidney recipients. Transplantation, 1997, 63(7): 964-967.
10.	Funaki S, Sawabata N, Nakagiri T, et al. Novel approach for detection of isolated tumor cells in pulmonary vein using negative selection method: morphological classification and clinical implications. Eur J Cardiothorac Surg, 2011, 40(2): 322-327.
11.	Brunsvig PF, Flatmark K, Aamdal S, et al. Bone marrow micrometastases in advanced stage non-small cell lung carcinoma patients. Lung Cancer, 2008, 61(2): 170-176.
12.	Sawabata N, Ohta M, Matsumura A, et al. Optimal distance of malignant negative margin in excision of nonsmall cell lung cancer: a multicenter prospective study. Ann Thorac Surg, 2004, 77(2): 415-420.
13.	Tartter PI, Burrows L, Kirschner P. Perioperative blood transfusion adversely affects prognosis after resection of Stage I (subset N0) non-oat cell lung cancer. J Thorac Cardiovasc Surg, 1984, 88(5 Pt 1): 659-662.
14.	Little AG, Wu HS, Ferguson MK, et al. Perioperative blood transfusion adversely affects prognosis of patients with stage I non-small-cell lung cancer. Am J Surg, 1990, 160(6): 630-632.
15.	Nosotti M, Rebulla P, Riccardi D, et al. Correlation between perioperative blood transfusion and prognosis of patients subjected to surgery for stage I lung cancer. Chest, 2003, 124(1): 102-107.
16.	Panagopoulos ND, Karakantza M, Koletsis E, et al. Influence of blood transfusions and preoperative anemia on long-term survival in patients operated for non-small cell lung cancer. Lung Cancer, 2008, 62(2): 273-280.
17.	Cata JP, Chukka V, Wang H, et al. Perioperative blood transfusions and survival in patients with non-small cell lung cancer: a retrospective study. BMC Anesthesiol, 2013, 13(1): 42.
18.	Cata JP, Gutierrez C, Mehran RJ, et al. Preoperative anemia, blood transfusion, and neutrophil-to-lymphocyte ratio in patients with stage Ⅰ non-small cell lung cancer. Cancer Cell Microenviron, 2016, 3(1): e1116.
19.	Ng T, Ryder BA, Chern H, et al. Leukocyte-depleted blood transfusion is associated with decreased survival in resected early-stage lung cancer. J Thorac Cardiovasc Surg, 2012, 143(4): 815-819.
20.	Thomas P, Michelet P, Barlesi F, et al. Impact of blood transfusions on outcome after pneumonectomy for thoracic malignancies. Eur Respir J, 2007, 29(3): 565-570.
21.	Moores DW, Piantadosi S, McKneally MF. Effect of perioperative blood transfusion on outcome in patients with surgically resected lung cancer. Ann Thorac Surg, 1989, 47(3): 346-351.
22.	陈敬华, 焦顺昌. 280 例非小细胞肺癌患者围手术期输血与否的预后关系. 中国肿瘤临床, 2007, 34(11): 632-935.
23.	Pastorino U, Valente M, Cataldo I, et al. Perioperative blood transfusion and prognosis of resected stage Ⅰa lung cancer. Eur J Cancer Clin Oncol, 1986, 22(11): 1375-1378.
24.	Keller SM, Groshen S, Martini N, et al. Blood transfusion and lung cancer recurrence. Cancer, 1988, 62(3): 606-610.
25.	Rzyman W, Dziadziuszko R, Skokowski J, et al. The influence of blood transfusion on survival in operated non-small cell lung cancer patients. J Thorac Cardiovasc Surg, 2003, 126(3): 755-760.
26.	Peñalver JC, Padilla J, Jordá C, et al. Use of blood products in patients treated surgically for stage I non-small cell lung cancer. Arch Bronconeumol, 2005, 41(9): 484-488.
27.	Ghosh S, Ahmed K, Hopkinson DN, et al. Pulmonary adenocarcinoma is associated with poor long-term survival after surgical resection. Effect of allogeneic blood transfusion. Cancer, 2004, 101(9): 2058-2066.
28.	Wu XL, Tu Q, Faure G, et al. Diagnostic and prognostic value of circulating tumor cells in head and neck squamous cell carcinoma: a systematic review and meta-analysis. Sci Rep, 2016, 6: 20210.
29.	Rosenberg SA, Seipp CA, White DE, et al. Perioperative blood transfusions are associated with increased rates of recurrence and decreased survival in patients with high-grade soft-tissue sarcomas of the extremities. J Clin Oncol, 1985, 3(5): 698-709.
30.	Tartter PI. The association of perioperative blood transfusion with colorectal cancer recurrence. Ann Surg, 1992, 216(6): 633-638.
31.	Asahara T, Katayama K, Itamoto T, et al. Perioperative blood transfusion as a prognostic indicator in patients with hepatocellular carcinoma. World J Surg, 1999, 23(7): 676-680.
32.	Sun C, Wang Y, Yao HS, et al. Allogeneic blood transfusion and the prognosis of gastric cancer patients: systematic review and meta-analysis. Int J Surg, 2015, 13: 102-110.
33.	Bordin JO, Heddle NM, Blajchman MA. Biologic effects of leukocytes present in transfused cellular blood products. Blood, 1994, 84(6): 1703-1721.
34.	van de Watering LM, Brand A, Houbiers JG, et al. Perioperative blood transfusions, with or without allogeneic leucocytes, relate to survival, not to cancer recurrence. Br J Surg, 2001, 88(2): 267-272.
35.	Blajchman MA, Bordin JO. The tumor growth-promoting effect of allogeneic blood transfusions. Immunol Invest, Jan-Feb 1995, 24(1-2): 311-317.
36.	Tomita M, Shimizu T, Hara M, et al. Impact of preoperative hemoglobin level on survival of non-small cell lung cancer patients. Anticancer Res, May-Jun 2008, 28(3B): 1947-1950.
37.	Ginsberg RJ, Rubinstein LV. Randomized trial of lobectomy versus limited resection for T1 N0 non-small cell lung cancer. Lung Cancer Study Group. Ann Thorac Surg, 1995, 60(3): 615-622.
38.	Latif MJ, Tan KS, Molena D, et al. Perioperative blood transfusion has a dose-dependent relationship with disease recurrence and survival in patients with non-small cell lung cancer. J Thorac Cardiovasc Surg, 2019, 157(6): 2469-2477.
39.	Churchhouse AM, Mathews TJ, McBride OM, et al. Does blood transfusion increase the chance of recurrence in patients undergoing surgery for lung cancer? Interact Cardiovasc Thorac Surg, 2012, 14(1): 85-90.

1. Sakin A, Sahin S, Yasar N, et al. Prognostic impact of blood transfusion in patients with metastatic non-small cell lung cancer receiving chemotherapy. Lung Cancer, 2019, 133: 38-44.
2. Arenberg D. Update on screening for lung cancer. Transl Lung Cancer Res, 2019, 8(Suppl 1): S77-S87.77-87.
3. Morgensztern D, Ng SH, Gao F, et al. Trends in stage distribution for patients with non-small cell lung cancer: a national cancer database survey. J Thorac Oncol, 2010, 5(1): 29-33.
4. Siegel R, Naishadham D, Jemal A. Cancer statistics, 2012. CA Cancer J Clin, Jan-Feb 2012, 62(1): 10-29.
5. Beale E, Zhu J, Chan L, et al. Blood transfusion in critically injured patients: a prospective study. Injury, 2006, 37(5): 455-465.
6. Cata JP, Wang H, Gottumukkala V, et al. Inflammatory response, immunosuppression, and cancer recurrence after perioperative blood transfusions. Br J Anaesth, 2013, 110(5): 690-701.
7. Zuck TF, Thomson RA, Schreiber GB, et al. The Retrovirus Epidemiology Donor Study (REDS): rationale and methods. Transfusion, Nov-Dec 1995, 35(11): 944-951.
8. Opelz G, Sengar DP, Mickey MR, et al. Effect of blood transfusions on subsequent kidney transplants. Transplant Proc, 1973, 5(1): 253-259.
9. Opelz G, Vanrenterghem Y, Kirste G, et al. Prospective evaluation of pretransplant blood transfusions in cadaver kidney recipients. Transplantation, 1997, 63(7): 964-967.
10. Funaki S, Sawabata N, Nakagiri T, et al. Novel approach for detection of isolated tumor cells in pulmonary vein using negative selection method: morphological classification and clinical implications. Eur J Cardiothorac Surg, 2011, 40(2): 322-327.
11. Brunsvig PF, Flatmark K, Aamdal S, et al. Bone marrow micrometastases in advanced stage non-small cell lung carcinoma patients. Lung Cancer, 2008, 61(2): 170-176.
12. Sawabata N, Ohta M, Matsumura A, et al. Optimal distance of malignant negative margin in excision of nonsmall cell lung cancer: a multicenter prospective study. Ann Thorac Surg, 2004, 77(2): 415-420.
13. Tartter PI, Burrows L, Kirschner P. Perioperative blood transfusion adversely affects prognosis after resection of Stage I (subset N0) non-oat cell lung cancer. J Thorac Cardiovasc Surg, 1984, 88(5 Pt 1): 659-662.
14. Little AG, Wu HS, Ferguson MK, et al. Perioperative blood transfusion adversely affects prognosis of patients with stage I non-small-cell lung cancer. Am J Surg, 1990, 160(6): 630-632.
15. Nosotti M, Rebulla P, Riccardi D, et al. Correlation between perioperative blood transfusion and prognosis of patients subjected to surgery for stage I lung cancer. Chest, 2003, 124(1): 102-107.
16. Panagopoulos ND, Karakantza M, Koletsis E, et al. Influence of blood transfusions and preoperative anemia on long-term survival in patients operated for non-small cell lung cancer. Lung Cancer, 2008, 62(2): 273-280.
17. Cata JP, Chukka V, Wang H, et al. Perioperative blood transfusions and survival in patients with non-small cell lung cancer: a retrospective study. BMC Anesthesiol, 2013, 13(1): 42.
18. Cata JP, Gutierrez C, Mehran RJ, et al. Preoperative anemia, blood transfusion, and neutrophil-to-lymphocyte ratio in patients with stage Ⅰ non-small cell lung cancer. Cancer Cell Microenviron, 2016, 3(1): e1116.
19. Ng T, Ryder BA, Chern H, et al. Leukocyte-depleted blood transfusion is associated with decreased survival in resected early-stage lung cancer. J Thorac Cardiovasc Surg, 2012, 143(4): 815-819.
20. Thomas P, Michelet P, Barlesi F, et al. Impact of blood transfusions on outcome after pneumonectomy for thoracic malignancies. Eur Respir J, 2007, 29(3): 565-570.
21. Moores DW, Piantadosi S, McKneally MF. Effect of perioperative blood transfusion on outcome in patients with surgically resected lung cancer. Ann Thorac Surg, 1989, 47(3): 346-351.
22. 陈敬华, 焦顺昌. 280 例非小细胞肺癌患者围手术期输血与否的预后关系. 中国肿瘤临床, 2007, 34(11): 632-935.
23. Pastorino U, Valente M, Cataldo I, et al. Perioperative blood transfusion and prognosis of resected stage Ⅰa lung cancer. Eur J Cancer Clin Oncol, 1986, 22(11): 1375-1378.
24. Keller SM, Groshen S, Martini N, et al. Blood transfusion and lung cancer recurrence. Cancer, 1988, 62(3): 606-610.
25. Rzyman W, Dziadziuszko R, Skokowski J, et al. The influence of blood transfusion on survival in operated non-small cell lung cancer patients. J Thorac Cardiovasc Surg, 2003, 126(3): 755-760.
26. Peñalver JC, Padilla J, Jordá C, et al. Use of blood products in patients treated surgically for stage I non-small cell lung cancer. Arch Bronconeumol, 2005, 41(9): 484-488.
27. Ghosh S, Ahmed K, Hopkinson DN, et al. Pulmonary adenocarcinoma is associated with poor long-term survival after surgical resection. Effect of allogeneic blood transfusion. Cancer, 2004, 101(9): 2058-2066.
28. Wu XL, Tu Q, Faure G, et al. Diagnostic and prognostic value of circulating tumor cells in head and neck squamous cell carcinoma: a systematic review and meta-analysis. Sci Rep, 2016, 6: 20210.
29. Rosenberg SA, Seipp CA, White DE, et al. Perioperative blood transfusions are associated with increased rates of recurrence and decreased survival in patients with high-grade soft-tissue sarcomas of the extremities. J Clin Oncol, 1985, 3(5): 698-709.
30. Tartter PI. The association of perioperative blood transfusion with colorectal cancer recurrence. Ann Surg, 1992, 216(6): 633-638.
31. Asahara T, Katayama K, Itamoto T, et al. Perioperative blood transfusion as a prognostic indicator in patients with hepatocellular carcinoma. World J Surg, 1999, 23(7): 676-680.
32. Sun C, Wang Y, Yao HS, et al. Allogeneic blood transfusion and the prognosis of gastric cancer patients: systematic review and meta-analysis. Int J Surg, 2015, 13: 102-110.
33. Bordin JO, Heddle NM, Blajchman MA. Biologic effects of leukocytes present in transfused cellular blood products. Blood, 1994, 84(6): 1703-1721.
34. van de Watering LM, Brand A, Houbiers JG, et al. Perioperative blood transfusions, with or without allogeneic leucocytes, relate to survival, not to cancer recurrence. Br J Surg, 2001, 88(2): 267-272.
35. Blajchman MA, Bordin JO. The tumor growth-promoting effect of allogeneic blood transfusions. Immunol Invest, Jan-Feb 1995, 24(1-2): 311-317.
36. Tomita M, Shimizu T, Hara M, et al. Impact of preoperative hemoglobin level on survival of non-small cell lung cancer patients. Anticancer Res, May-Jun 2008, 28(3B): 1947-1950.
37. Ginsberg RJ, Rubinstein LV. Randomized trial of lobectomy versus limited resection for T1 N0 non-small cell lung cancer. Lung Cancer Study Group. Ann Thorac Surg, 1995, 60(3): 615-622.
38. Latif MJ, Tan KS, Molena D, et al. Perioperative blood transfusion has a dose-dependent relationship with disease recurrence and survival in patients with non-small cell lung cancer. J Thorac Cardiovasc Surg, 2019, 157(6): 2469-2477.
39. Churchhouse AM, Mathews TJ, McBride OM, et al. Does blood transfusion increase the chance of recurrence in patients undergoing surgery for lung cancer? Interact Cardiovasc Thorac Surg, 2012, 14(1): 85-90.

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