Effects of omega-3 fatty acids supplementation on perioperative blood loss and complications after radical prostatectomy

Background and aims: Many dietary supplements, including omega-3 fatty acids (omega 3), are suspected to affect blood coagulation and platelet function. Despite no clinical evidence, discontinuation is recommended before radical prostatectomy. However, long-chain omega 3 (LC omega 3) appear beneficial against prostate cancer progression. Here, we aim to determine the effect of LC omega 3 supplements on perioperative bleeding, hemoglobin, platelets, and postoperative complications after radical prostatectomy. Methods: This is a planned exploratory analysis of 130 patients diagnosed with prostate cancer grade group 2 or greater enrolled in a randomized controlled trial (NCT02333435) testing the effects of LC omega 3, on prostate cancer biological and pathological outcomes at radical prostatectomy as main outcomes. The LC omega 3 intervention (MAG-EPA 3 g daily) or equivalent placebo was given 4-10 weeks prior to radical prostatectomy. An intention-to-treat analysis approach was used with bi-variate statistical testing of bleeding and complications outcomes. We also estimated the difference between groups using linear regression and non-parametric quantile regression models. All models were adjusted for confounding variables selected on clinical relevance. Results: We found no clinically significant effect of LC omega 3 versus placebo on perioperative bleeding, laboratory tests or postoperative complications. In contrast, as expected, we found a significant increase in perioperative bleeding in open retropubic radical prostatectomy compared to robot-assisted radical prostatectomy (adjusted difference 115.8 mL, p = 0.04). Conclusions: Our results suggest that omega 3 supplements can be safely taken before radical prostatectomy without increasing surgical bleeding risk. These findings are relevant since ?3 may beneficially affect prostate cancer evolution. (C) 2021 The Author(s). Published by Elsevier Ltd on behalf of European Society for Clinical Nutrition and Metabolism.

Automated summary

The aim of this study was to determine the effect of long-chain omega-3 (LC omega-3) supplements on perioperative bleeding and complications after radical prostatectomy. The results showed that taking LC omega-3 supplements before the surgery did not increase the risk of surgical bleeding.