Tranexamic acid use in sarcoma surgery patients: A systematic review and meta-analysis.

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  • Additional Information
    • Source:
      Publisher: Wiley-Liss Country of Publication: United States NLM ID: 0222643 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1096-9098 (Electronic) Linking ISSN: 00224790 NLM ISO Abbreviation: J Surg Oncol Subsets: MEDLINE
    • Publication Information:
      Publication: <2005-> : Hoboken, NJ : Wiley-Liss
      Original Publication: New York, Plenum.
    • Subject Terms:
      Antifibrinolytic Agents*/administration & dosage ; Antifibrinolytic Agents*/adverse effects ; Blood Loss, Surgical*/prevention & control ; Blood Loss, Surgical*/statistics & numerical data ; Sarcoma*/surgery ; Tranexamic Acid*/administration & dosage ; Tranexamic Acid*/adverse effects; Humans
    • Abstract:
      Introduction: Perioperative bleeding increases morbidity and mortality in sarcoma patients. Tranexamic acid (TXA), an antifibrinolytic, is widely utilized in non-sarcoma orthopaedic surgeries, but its adoption in sarcoma surgery is hindered by concerns about thrombotic events.
      Methods: Searches in Ovid MEDLINE, EMBASE, and CENTRAL were performed without date restrictions. Inclusion criteria encompassed sarcoma patients undergoing surgery with TXA intervention. Two authors independently screened studies, resolved conflicts, and assessed biases.
      Results: Eight studies met inclusion criteria, comprising 2142 patients. TXA administration varied in dose and timing across studies. Meta-analysis revealed significantly reduced mean blood loss with TXA of -462.5 mL ([95% confidence interval [CI: -596.7, -328.31], p < 0.001) but no difference in transfusion rates (odds ratio [OR] = 0.51 [95% CI: 0.14-1.89]) or venous thromboembolism events (OR = 0.93 [95% CI: 0.40, 2.16]). Study biases were predominantly moderate to high due to retrospective designs and lack of control for confounders. Quality of reporting varied, with limitations identified in outcome reporting and effect size estimation.
      Conclusions: Despite evidence of reduced blood loss, the absence of prospective studies limits conclusive recommendations on TXA use in sarcoma surgery. Further research is warranted to determine optimal TXA regimens and assess safety concerns regarding thrombotic events in this patient population.
      (© 2024 The Author(s). Journal of Surgical Oncology published by Wiley Periodicals LLC.)
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    • Contributed Indexing:
      Keywords: antifibrinolytic; blood loss; meta‐analysis; sarcoma; surgery; systematic review; tranexamic acid; venous thromboembolism
    • Accession Number:
      0 (Antifibrinolytic Agents)
      6T84R30KC1 (Tranexamic Acid)
    • Publication Date:
      Date Created: 20240730 Date Completed: 20241015 Latest Revision: 20241101
    • Publication Date:
      20241101
    • Accession Number:
      10.1002/jso.27793
    • Accession Number:
      39076132