Investigators aimed to compare the effect on different indications (blood volume loss based VS hemoglobin concentration based ) based blood transfusion practices in patients undergoing major oncological surgery for pelvic or spinal tumor and investigate their postoperative complications.

260 patients underwent major oncological surgery for open pelvic or spinal tumor resection were included in this study. We looked at white blood cells, hemoglobin, hematocrit, neutrophil ratio, C-reactive protein, erythrocyte sedimentation rate, and IL-6 levels 1 day, 3 days, and 7 days after surgery The main question it sought to answer was whether there was a difference in postoperative complications 30 days after surgery between patients who received blood transfusions based on volume loss and those who received blood transfusions based on hemoglobin concentration during surgery.

Inclusion Criteria:

• age between 18 and 70
• patients with pelvic or spinal tumor
• conduct open resection surgery for tumor removal
• with expected surgery duration greater than 3 hours
• with expected blood loss greater than 400 ml

Exclusion Criteria:

• age < 18 or >70
• Limb tumor patients or patients with pelvic and spinal tumors undergoing closed internal fixation or vertebroplasty or minimally invasive surgery
• received chemotherapy or immunotherapy before surgery
• with expected surgery length less than 3 hours
• with expected intraoperative blood loss less than 400ml