Journal of Multidisciplinary Healthcare (Jul 2022)

Efficacy and Safety of Tranexamic Acid in Cancer Surgery. An Update of Clinical Findings and Ongoing Research

  • Zec T,
  • Di Napoli R,
  • Fievez L,
  • Ben Aziz M,
  • Ottaiano A,
  • Vittori A,
  • Perri F,
  • Cascella M

Journal volume & issue
Vol. Volume 15
pp. 1427 – 1444

Abstract

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Tamara Zec,1 Raffaela Di Napoli,1 Lydwine Fievez,1 Mohamed Ben Aziz,1 Alessandro Ottaiano,2 Alessandro Vittori,3 Francesco Perri,4 Marco Cascella5 1Department of Anesthesiology, Institut Jules Bordet, Université Libre de Bruxelles, Bruxelles, 1000, Belgium; 2SSD Innovative Therapies for Abdominal Metastases, Istituto Nazionale Tumori, IRCCS Fondazione G. Pascale, Naples, 80100, Italy; 3Department of Anesthesia and Critical Care, ARCO ROMA, Ospedale Pediatrico Bambino Gesù IRCCS, Piazza S. Onofrio 4, Rome, 00165, Italy; 4Medical and Experimental Head and Neck Oncology Unit, Istituto Nazionale Tumori IRCCS Fondazione G. Pascale, Naples, 80100, Italy; 5Division of Anesthesia and Pain Medicine, Istituto Nazionale Tumori, IRCCS Fondazione G. Pascale, Naples, 80100, ItalyCorrespondence: Francesco Perri, Email [email protected]: In cancer patients undergoing surgery, tumor biology and anticancer treatments can increase the risk of perioperative bleeding and blood transfusions. Notably, blood transfusions can be potentially associated with an increased risk of life-threatening immune responses, acute lung injury, postoperative infections, and thromboembolism. Moreover, the link between perioperative transfusion and increased risk of cancer recurrence cannot be excluded. On the other hand, cancer patients have an increased risk of thromboembolism due to cancer itself and antineoplastic systemic treatments including chemotherapy and anti-angiogenic drugs. In this complex scenario, effective and safe strategies aimed at the prevention of blood transfusions are warranted. This narrative review addresses the efficacy, and the safety of the synthetic antifibrinolytic agent tranexamic acid (TXA) when used perioperatively in cancer surgery. Although in not oncologic surgery the use of TXA has been extensively studied, in the setting of cancer patients requiring surgery, the evidence is scarce. An overview of the ongoing clinical research is also provided.Keywords: tranexamic acid, cancer surgery, oncology, anemia, blood transfusion, anti-fibrinolytic

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