Kawai et al identified factors affecting blood loss and the need for blood transfusion for patients undergoing surgery for a musculoskeletal tumor. These can help to identify a patient who may benefit from more aggressive management or a change in procedure. The authors are from the National Cancer Center Hospital in Tokyo.


Factors associated with blood loss and the need for transfusion:

(1) bone tumor > soft tissue tumor

(2) amputation/disarticulation and wide excision > marginal resection and biopsy

(3) long operations > short operations



• Amputation and wide excisions imply a malignant tumor.



• minimum number of factors: 0

• maximum number of factors: 3

• The more factors that are present the greater the risk of significant blood loss.


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