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Review
. 2025 Jun;41(6):1818-1825.
doi: 10.12669/pjms.41.6.11293.

Perioperative blood transfusion and the prognosis of ovarian cancer surgery: A meta-analysis

Qian-Yi Huang  1 , Ya-Xin Huang  2 , Wan-Yang Mu  3 , Peng-Cheng Li  4
Affiliations
Review

Perioperative blood transfusion and the prognosis of ovarian cancer surgery: A meta-analysis

Qian-Yi Huang et al. Pak J Med Sci. 2025 Jun.

Abstract

Background and objective: Perioperative blood transfusion (PBT) is a common procedure in ovarian cancer (OC) surgery, which may be a deleterious prognosis predictor. Therefore, this study aimed to assess the impact of PBT on survival indicators in OC patients using meta-analysis.

Methods: This study was performed in adherence to the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines. Relevant articles were collected by searching the PubMed, Embase, Google Scholar, and Cochrane Library databases up to September 30, 2024. A random-effects model was used to calculate pooled hazard ratios (HRs). Sensitivity analysis, sub-analysis, and publication bias were evaluated.

Results: This study included nine studies, including 3,727 OC patients. 53.4% of the patients received transfusions. Overall, PBT was associated with shorter overall survival (OS), with pooled HRs of 1.44 (95% CI 1.21-1.71; P < 0.001, I2 = 60.4%) and 1.55 (95% CI 1.17-2.06; P < 0.001, I2 = 79.5%) for OS and progression-free survival (PFS), respectively. This result was also obtained using sensitivity analysis. Subgroup analysis revealed the greater impact of PBT on OS in the early OC stage than in the late stage.

Conclusions: The patients receiving PBT exhibited lower survival after OC surgery, and this impact was more pronounced in early-stage patients.

Keywords: Meta-analysis; Ovarian cancer; Perioperative blood transfusion; Prognosis.

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Conflict of interest statement

Conflict of interests: None.

Figures

Fig.1
Fig.1
Flow diagram of search and study selection.
Fig.2
Fig.2
Forest plot depicting hazard ratios and 95 % confidence interval of overall survival for perioperative blood transfusion.
Fig.3
Fig.3
Forest plot depictinghazard ratios and 95 % confidence interval of progression free survival for perioperative blood transfusion.
Fig.4
Fig.4
Sensitivity analysis of the relationship between Perioperative blood transfusion and overall survival.
Fig.5
Fig.5
Forest plot depicting hazard ratios and 95 % confidence interval of overall survival based on propensity score matching analysis results.
Fig.6
Fig.6
Forest plot for the association between perioperative blood transfusion and overall survival in terms of subgroup analysis.
Fig.7
Fig.7
Begger’s funnel plot for the publication bias test of overall survival.
Fig.8
Fig.8
Egger’s funnel plot for the publication bias test of overall survival.
See this image and copyright information in PMC

References

    1. Ali AT, Al-Ani O, Al-Ani F. Epidemiology and risk factors for ovarian cancer. Prz Menopauzalny. 2023;22(2):93–104. doi:10.5114/pm.2023.12⇕. - PMC - PubMed
    1. Siegel RL, Miller KD, Wagle NS, Jemal A. Cancer statistics, 2023. CA Cancer J Clin. 2023;73(1):17–48. doi:10.3322/caac.21763. - PubMed
    1. Chishti U, Aziz AB. Primary debulking surgery versus neo-adjuvant chemotherapy in stage III/IV ovarian cancer:Comparison of perioperative morbidity and survival data in Pakistani women. J Pak Med Assoc. 2015;65(3):306–309. - PubMed
    1. Aguilar-Nascimento JE, Zampieri-Filho JP, Bordin JO. Implications of perioperative allogeneic red blood cell transfusion on the immune-inflammatory response. Hematol Transfus Cell Ther. 2021;43(1):58–64. doi:10.1016/j.htct.2020.03.003. - PMC - PubMed
    1. Sun C, Wang Y, Yao HS, Hu ZQ. Allogeneic blood transfusion and the prognosis of gastric cancer patients:systematic review and meta-analysis. Int J Surg. 2015;13:102–110. doi:10.1016/j.ijsu.2014.11.044. - PubMed

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