Peri-operative blood transfusion and ovarian cancer survival rates: A systematic review and meta-analysis.

Abstract

e17552 Background: Ovarian cancer is the most lethal gynecologic tumor, the 5-year survival is less than 40%. Perioperative blood transfusions are a common practice during ovarian cancer surgery, can have a negative impact that extends beyond the immediate postoperative period, potentially having detrimental effects on immune function and may therefore influence disease progression and survival outcomes. Methods: PubMed, Embase, and Cochrane databases were systematically searched for studies evaluating the survival rates of perioperative blood transfusion on patients with ovarian cancer from inception up to December 2024. The outcomes assessed were overall survival and overall mortality. Statistical analysis was performed using Rstudio 4.3.1. Heterogeneity was assessed with I2 statistics, and a random-risk effect was used if i12 > 50%. Results: Eight studies met inclusion criteria, 4 retrospective cohorts, 2 retrospective studies, 1 randomized clinical trial and 1 retrospective chart review. A total of 9.237patients were included, of whom 3.991 (43,2%) women were transfused. Over a mean follow-up time ranging from 1 year to 10 years, the histologic type of cancer were epithelial (74%), serous (15,4%), mucinous (0,5%),clear cell (0,2%), endometrioid (0,75%), undifferentiated (1%), mixed (0,08%) and unclassified (8,07%). It was observed a statistically significant overall survival (HR= 1,29, 95% Cl, 0.9–1.59, p = 0.3; 0.6; I2 = 58.5%), overall mortality (HR= 1,28, 95% Cl, 1.30–2.24, p = 0.2; 0.2; I2 = 43.9%) and disease free survival (HR= 1,28, 95% Cl, 1.12–1.46, p = 0.0004; I2 = 58%). Conclusions: Perioperative blood transfusions may be associated with worse survival outcomes in ovarian cancer patients. These findings highlight the importance of strategies aimed at minimizing the need for blood transfusions during the perioperative period. Further prospective studies are required to elucidate the underlying mechanisms and confirm the causality of this association.