Transfusion Medicine
Sujata Mallick; Mahasweta Mallik; Puskar Shyam Chowdhury
Abstract
Background & Objective: Background and objective: Perioperative blood transfusion (PBT) during radical urological surgeries has been associated with an increased incidence of complications. The present study analyzes the outcome of perioperative blood transfusion (PBT) and the prognostic implications ...
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Background & Objective: Background and objective: Perioperative blood transfusion (PBT) during radical urological surgeries has been associated with an increased incidence of complications. The present study analyzes the outcome of perioperative blood transfusion (PBT) and the prognostic implications after radical surgeries on patients with malignant urological tumors.Methods: Our retrospective study included 792 cases of partial or radical nephrectomy /cystectomy/prostatectomy surgeries for kidney/bladder/ prostate carcinoma from 2012 to 2022. Data on preoperative, intraoperative, and pathological parameters were evaluated. PBT was taken as a period of transfusion of allogenic RBC during/preoperative/postoperative surgeries. The effect of PBT on oncological parameters like recurrence-free survival (RFS), overall survival (OS), and cancer-free survival (CSS) was compared using univariate cox regression analysis (Odds ratio, Hazard ratio).Results: PBT was applied on 124 (20.6%) patients of nephrectomy, 54 (46.5%) patients of cystectomy, and 23 (31%) patients of prostatectomy. The baseline characteristics of the cohort study found symptomatic patients with older age and other co-morbidities to be transfusion-dependent. Also, the patients undergoing radical operations with more blood loss and advanced tumor stage were more likely to receive PBT. PBT was significantly associated with survival outcomes (P<0.05) in nephrectomy and cystectomy cases but independent of association in prostatectomy cases.Conclusion: The result of this study concludes that in nephrectomy and cystectomy operations, PBT had a significant association with cancer recurrence and mortality; however, in prostatectomy cases, no significant correlation was noted. Thus, proper criteria to prevent the unnecessary use of PBT and more defined parameters for transfusion are needed to improve postoperative survival. Autologous transfusion should be considered more frequently. However, more extensive studies and randomized trials are needed in this area.
Breast Pathology
Sujata Mallick; Mahasweta Mallik; Rabindra Nath Chatterjee; Puskar Shyam Chowdhury
Abstract
Background & Objective: Liver lesions are difficult to diagnose and to differentiate primary from metastatic carcinoma, while Biopsy has its limitations. Cell block technology is easily accessible with high diagnostic accuracy. Our aim is 1) To find the role of cell block technology as an alternative ...
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Background & Objective: Liver lesions are difficult to diagnose and to differentiate primary from metastatic carcinoma, while Biopsy has its limitations. Cell block technology is easily accessible with high diagnostic accuracy. Our aim is 1) To find the role of cell block technology as an alternative to biopsy in identifying liver lesions; 2) To find the efficacy of cell block along with immunohistochemistry (IHC) and ancillary studies in differentiating primary from metastatic lesions; 3) To identify the site of origin of metastatic lesions. This is a descriptive study undertaken in two tertiary care hospitals over a period of three years.Methods: Retrospective review of adequate samples from fine needle aspirations from liver lesions under radiological coverage, converted into cell block was done. IHC was applied as needed. Usefulness of cell block preparation was evaluated, and the final diagnosis correlated with the biopsy results.Results: Analysis of 323 cases found sensitivity of 98.75% and positive predictive value of 99% for all lesions. Sensitivity for metastatic carcinomas was slightly more than hepatocellular carcinoma. However, accuracy of cell block results for individual metastatic lesions and site of origin was less. IHC and morphological pattern worked as an important adjunct in the final diagnosis. On the other hand, contribution of viral markers as a supplement in the final work up was ambiguous. Conclusion: High precision of validity results of cell block technology in comparison with biopsy highlights its pivotal role in conjunction with supportive tests for diagnosing and differentiating liver lesions as well as identifying primary sites in liver metastasis.
