TXA use was associated with a numerically lower perioperative transfusion requirement in proximal femoral megaprosthetic reconstruction for metastatic bone disease, although the difference was not statistically significant, and these findings should be considered exploratory and hypothesis-generating.
Perioperative blood transfusion rates were numerically lower in the TXA group but the difference did not reach statistical significance.
The mean number of transfused erythrocyte units was similar between the TXA and control groups.
Hospital length of stay was numerically shorter in the TXA group but did not reach statistical significance.
No clinically documented symptomatic thromboembolic events were observed in either group.
The study was a small retrospective cohort spanning 2019 to 2026, limiting the strength of conclusions drawn.
This research suggests that giving a medication called tranexamic acid (TXA) — which helps blood clot and reduces bleeding — before major surgery to replace part of the thigh bone (femur) with an artificial implant in cancer patients may reduce the need for blood transfusions. In this study of 32 patients, about 60% of those who received TXA needed a blood transfusion during or after surgery, compared to about 82% of those who did not receive TXA. Patients who received TXA also spent roughly 4 fewer days in the hospital on average. Importantly, no dangerous blood clots (a known concern with TXA) were detected in any patient in either group. However, none of these differences were statistically significant, meaning the results could have occurred by chance given how few patients were in the study. The authors were careful to note that these findings should be treated as preliminary and are not strong enough to change clinical practice on their own. This type of surgery — removing cancerous bone and replacing it with a large metal implant — tends to cause significant blood loss, so finding effective ways to reduce transfusion needs is clinically important, particularly in cancer patients who may already be medically fragile. This research suggests that TXA may be a safe and potentially beneficial addition to surgical care for this patient population, but larger, well-designed prospective studies are needed before firm conclusions can be drawn. The study provides a foundation for future research rather than definitive evidence.
Yalçin E, Sünbül H, Torunlar M, Topkaya Y, Uslu O, Kaya A. (2026). Tranexamic acid in proximal femoral megaprosthetic reconstruction for metastatic bone disease: A retrospective comparative study.. Medicine. https://doi.org/10.1097/MD.0000000000050737