%0 Journal Article
%T Intraoperative Blood Loss Independently Predicts Survival and Recurrence after Resection of Colorectal Cancer Liver Metastasis
%A Wu Jiang
%A Yu-Jing Fang
%A Xiao-Jun Wu
%A Fu-Long Wang
%A Zhen-Hai Lu
%A Rong-Xin Zhang
%A Pei-Rong Ding
%A Wen-Hua Fan
%A Zhi-Zhong Pan
%A De-Sen Wan
%J PLOS ONE
%D 2013
%I Public Library of Science (PLoS)
%R 10.1371/journal.pone.0076125
%X Background Although numerous prognostic factors have been reported for colorectal cancer liver metastasis (CRLM), few studies have reported intraoperative blood loss (IBL) effects on clinical outcome after CRLM resection. Methods We retrospectively evaluated the clinical and histopathological characteristics of 139 patients who underwent liver resection for CRLM. The IBL cutoff volume was calculated using receiver operating characteristic curves. Overall survival (OS) and recurrence free survival (RFS) were assessed using the Kaplan每Meier and Cox regression methods. Results All patients underwent curative resection. The median follow up period was 25.0 months (range, 2.1每88.8). Body mass index (BMI) and CRLM number and tumor size were associated with increased IBL. BMI (P=0.01; 95% CI = 1.3每8.5) and IBL (P<0.01; 95% CI = 1.6每12.5) were independent OSOs predictors. Five factors, including IBL (P=0.02; 95% CI = 1.1每4.1), were significantly related to RFS via multivariate Cox regression analysis. In addition, OSOs and RFS significantly decreased with increasing IBL volumes. The 5-year OSOs of patients with IBL≒250, 250每500, and >500mL were 71%, 33%, and 0%, respectively (P<0.01). RFS of patients within three IBL volumes at the end of the first year were 67%, 38%, and 18%, respectively (P<0.01). Conclusions IBL during CRLM resection is an independent predictor of long term survival and tumor recurrence, and its prognostic value was confirmed by a dose每response relationship.
%U http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0076125