{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,25]],"date-time":"2025-11-25T04:58:13Z","timestamp":1764046693903,"version":"3.37.3"},"reference-count":40,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2018,5,14]],"date-time":"2018-05-14T00:00:00Z","timestamp":1526256000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100009720","name":"Jerold B. Katz Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009720","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["TL1TR000456","UL1TR000454"],"award-info":[{"award-number":["TL1TR000456","UL1TR000454"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Surgical Oncology"],"published-print":{"date-parts":[[2018,6]]},"abstract":"<jats:sec><jats:title>Background and Objectives<\/jats:title><jats:p>Perioperative blood transfusion is associated with poor outcomes in several malignancies. Its effect in gallbladder cancer (GBC) is unknown.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>All patients with GBC who underwent curative\u2010intent resection at 10\u2010institutions from 2000 to 2015 were included. The effect of blood transfusion on overall survival (OS) and recurrence\u2010free (RFS) was evaluated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 262 patients with curative\u2010intent resection for GBC, 61 patients (23%) received blood transfusions. Radical cholecystectomy was the most common procedure (80%), but major hepatectomy was more frequent in the transfusion versus no\u2010transfusion group (13% vs 4%; <jats:italic>P<\/jats:italic>\u2009=\u20090.02). The transfusion group was less likely to have incidentally discovered disease (57% vs 74%) and receive adjuvant therapy (29% vs 48%), but more likely to have preoperative jaundice (23% vs 11%), T3\/T4 tumors (60% vs 39%), LVI (71% vs 40%), PNI (71% vs 48%), and major complications (39% vs 12%) (all <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05). Transfusion was associated with lower median OS compared to no\u2010transfusion (20 vs 32\u2009mos; <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001), which persisted on multivariable (MV) analysis (HR:1.9; 95%CI 1.1\u20103.5; <jats:italic>P<\/jats:italic>\u2009=\u20090.035), controlling for comorbidities, serum albumin, INR, preoperative jaundice, major hepatectomy, incidental discovery, margin status, T\u2010Stage, LN status, and major complications. Median RFS of transfused patients was 13mo compared to 49mo for non\u2010transfused patients (<jats:italic>P<\/jats:italic>\u2009=\u20090.1). Transfusion, however, was an independent predictor of decreased RFS on MV analysis (HR:2.3; 95%CI 1.1\u20105.1; <jats:italic>P<\/jats:italic>\u2009=\u20090.035).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Perioperative blood transfusion is associated with decreased OS and RFS after resection for GCC, accounting for other adverse factors. Transfusions should thus be administered with well\u2010defined protocols.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jso.25086","type":"journal-article","created":{"date-parts":[[2018,5,15]],"date-time":"2018-05-15T02:30:54Z","timestamp":1526351454000},"page":"1638-1647","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Association of perioperative transfusion with survival and recurrence after resection of gallbladder cancer: A 10\u2010institution study from the US Extrahepatic Biliary Malignancy Consortium"],"prefix":"10.1002","volume":"117","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7928-4901","authenticated-orcid":false,"given":"Alexandra G.","family":"Lopez\u2010Aguiar","sequence":"first","affiliation":[{"name":"Division of Surgical Oncology, Department of Surgery Winship Cancer Institute, Emory University Atlanta Georgia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cecilia G.","family":"Ethun","sequence":"additional","affiliation":[{"name":"Division of Surgical Oncology, Department of Surgery Winship Cancer Institute, Emory University Atlanta Georgia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mia R.","family":"McInnis","sequence":"additional","affiliation":[{"name":"Division of Surgical Oncology, Department of Surgery Winship Cancer Institute, Emory University Atlanta Georgia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4828-8096","authenticated-orcid":false,"given":"Timothy M.","family":"Pawlik","sequence":"additional","affiliation":[{"name":"Division of Surgical Oncology, Department of Surgery The Johns Hopkins Hospital Baltimore Maryland"},{"name":"Division of Surgical Oncology The Ohio State University Comprehensive Cancer Center Columbus Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"George","family":"Poultsides","sequence":"additional","affiliation":[{"name":"Department of Surgery Stanford University Medical Center Stanford California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thuy","family":"Tran","sequence":"additional","affiliation":[{"name":"Department of Surgery Stanford University Medical Center Stanford California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kamran","family":"Idrees","sequence":"additional","affiliation":[{"name":"Division of Surgical Oncology, Department of Surgery Vanderbilt University Medical Center Nashville Tennessee"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chelsea A.","family":"Isom","sequence":"additional","affiliation":[{"name":"Division of Surgical Oncology, Department of Surgery Vanderbilt University Medical Center Nashville Tennessee"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryan C.","family":"Fields","sequence":"additional","affiliation":[{"name":"Department of Surgery Washington University School of Medicine St Louis Missouri"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bradley A.","family":"Krasnick","sequence":"additional","affiliation":[{"name":"Department of Surgery Washington University School of Medicine St Louis Missouri"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sharon M.","family":"Weber","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Wisconsin School of Medicine and Public Health Madison Wisconsin"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahmed","family":"Salem","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Wisconsin School of Medicine and Public Health Madison Wisconsin"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert C. 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