A trial comparing 2 ways of having a blood transfusion during surgery for ovarian cancer (TIC TOC)

Cancer type:

Ovarian cancer

Status:

Results

Phase:

Other

This trial compared people having blood donated from a volunteer with people having their own blood returned to them. It was for women having an operation for advanced ovarian cancer.

Collecting someone’s blood and giving it back to them during surgery is called intraoperative cell salvage, or ICS.

The trial was open for people to join between 2016 and 2018. The team presented some results at a conference in 2019.

More about this trial

Doctors often treat ovarian cancer with surgery. Sometimes people need a blood transfusion during their operation. When this trial was done, doctors usually used blood that had been donated by a healthy volunteer. This is organised by the NHS Blood and Transplant service.

Blood transfusions from a donor are generally very safe and have been used for many decades. But there are some rare side effects that can happen, including:

an increased risk of wound infections or other infections
lung and kidney problems

There is also a very small risk of receiving the wrong blood type. But this is very rare.

Researchers wanted to find out if it is better to give people back their own blood. They can collect, filter and return a person’s blood during surgery. This is called intraoperative cell salvage (ICS).

When this trial was done, doctors were already using ICS during some operations. There was some evidence that it might help people to recover after surgery.

The main aims of this trial were to find out:

if it’s possible to run a larger trial looking at ICS
if ICS is better than using blood donated by a healthy volunteer
which type of blood transfusion is most cost effective

Summary of results

The research team found that it was safe to give people their own blood during surgery for ovarian cancer.

Results
A total of 57 people joined this trial. Two people weren’t well enough to have surgery so 55 were put into a treatment group at random. There were:

29 people in donated blood group
26 people in the intraoperative cell salvage (ICS) group

TIC TOC- Randomization

Of those, 30 needed a blood transfusion during their operation:

• 14 out of 29 people (48%) had blood donated by a healthy volunteer
• 16 out of 26 people (62%) had their own blood returned to them

Side effects
The research team looked at the number of people in each group who had an infection after their operation. The most common were wound, urine and lung infections.

They found it was:

• 13 out of 29 people (45%) in the donated blood group
• 9 out of 26 people (35%) in the ICS group

TIC TOC -bar-chart

Conclusion
The research team concluded that it was safe to collect and return blood to people during surgery for ovarian cancer. And that this could be a good alternative to using blood donated by a healthy volunteer.

They suggest this is looked at in larger trials to find out more about how well it works.

Where this information comes from
We have based this summary on information from the research team. The information they sent us has been reviewed by independent specialists peer reviewed Open a glossary item but may not have been published in a medical journal. The figures we quote above were provided by the research team. We have not analysed the data ourselves.