Evidence map›Paper›PMID 39775775›Full record

SynthesisAnaesthesia2025

Association between peri-operative red blood cell transfusion and cancer recurrence in patients undergoing major cancer surgery: an umbrella review.

Joshua Etheridge, Panth Shah, Simon J Stanworth, Ewen Harrison, Michael Gillies, Timothy S Walsh, Akshay Shah

Abstract readSystematic Review
In one paragraph

Synthesis in Anaesthesia, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Joshua EtheridgeDepartment of Anaesthesia, Pain and Critical Care Medicine, Royal Infirmary of Edinburgh, Edinburgh, UK.
Panth ShahUsher Institute of Population Health Sciences, The University of Edinburgh, Edinburgh, UK.
Simon J StanworthNIHR Blood and Transplant Research Unit in Data Driven Transfusion Practice, University of Oxford, Oxford, UK.ORCID 0000-0002-7414-4950
Ewen HarrisonCentre for Medical Informatics, University of Edinburgh, Edinburgh, UK.ORCID 0000-0002-5018-3066
Michael GilliesDepartment of Anaesthesia, Pain and Critical Care Medicine, Royal Infirmary of Edinburgh, Edinburgh, UK.ORCID 0000-0003-1909-0790
Timothy S WalshDepartment of Anaesthesia, Pain and Critical Care Medicine, Royal Infirmary of Edinburgh, Edinburgh, UK.ORCID 0000-0002-3590-8540
Akshay ShahNuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK.ORCID 0000-0002-1869-2231

Funding

National Institute for Health and Care Research NIHR20334
6 · The paper itself

Abstract

introductionPeri-operative allogeneic red blood cell transfusion is hypothesised to increase the risk of cancer recurrence following cancer surgery. However, previous data supporting this association are limited by residual confounding. We conducted an umbrella review (i.e. a systematic review of systematic reviews) to synthesise and evaluate the evidence between red blood cell transfusion and cancer recurrence.

methodsWe searched online databases for systematic reviews of red blood cell transfusion and cancer-related outcomes. The AMSTAR 2 tool was used for quality assessment. The adequacy of confounding adjustment was judged according to a consensus-derived framework.

resultsWe included five relevant systematic views which included patient populations ranging from 2110 to 184,190. Two reviews reported cancer recurrence, and all reported an association with red blood cell transfusion. Three reviews reported positive associations between red blood cell transfusion and adverse outcomes including all-cause mortality, recurrence-free survival and cancer-related mortality. According to AMSTAR 2, four reviews were rated as 'critically low quality' and one as 'low quality'. There was variation in how systematic reviews assessed the risk of bias from confounding. Compared with our pre-derived framework, we found a high likelihood of unmeasured confounding. DISCUSSION: Currently available evidence describes an association between peri-operative red blood cell transfusion and cancer recurrence, but this is mostly of low to critically low quality, with minimal control for residual confounding. Further research, at low risk of bias, is required to provide definitive evidence and inform practice.

Indexed as

Erythrocyte TransfusionNeoplasm Recurrence, LocalNeoplasmsPerioperative CareHumansSystematic Reviews as Topiccancerperi‐operative carered blood cellstransfusion

Identifiers

PMID39775775
PMCPMC11744431

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.