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. 2015 Apr;56(4):295-304.
doi: 10.4111/kju.2015.56.4.295. Epub 2015 Mar 26.

The prognostic impact of perioperative blood transfusion on survival in patients with bladder urothelial carcinoma treated with radical cystectomy

Joong Sub Lee  1 , Hyung Suk Kim  1 , Chang Wook Jeong  1 , Cheol Kwak  1 , Hyeon Hoe Kim  1 , Ja Hyeon Ku  1
Affiliations

The prognostic impact of perioperative blood transfusion on survival in patients with bladder urothelial carcinoma treated with radical cystectomy

Joong Sub Lee et al. Korean J Urol. 2015 Apr.

Abstract

Purpose: The aim of our study was to assess the influence of perioperative blood transfusion (PBT) on survival outcomes following radical cystectomy (RC) and pelvic lymph node dissection (PLND).

Materials and methods: We reviewed and analyzed the clinical data of 432 patients who underwent RC for bladder cancer from 1991 to 2012. PBT was defined as the transfusion of allogeneic red blood cells during RC or postoperative hospitalization.

Results: Of all patients, 315 patients (72.9%) received PBT. On multivariate logistic regression analysis, female gender (p=0.015), a lower preoperative hemoglobin level (p=0.003), estimated blood loss>800 mL (p<0.001), and performance of neoadjuvant chemotherapy (p<0.001) were independent risk factors related to requiring perioperative transfusions. The receipt of PBT was associated with increased overall mortality (hazard ratio, 1.91; 95% confidence interval, 1.25-2.94; p=0.003) on univariate analysis, but its association was not confirmed by multivariate analysis (p=0.058). In transfused patients, a transfusion of >4 packed red blood cell units was an independent predictor of overall survival (p=0.007), but not in cancer specific survival.

Conclusions: Our study was not conclusive to detect a clear association between PBT and survival after RC. However, the efforts should be made to continue limiting the overuse of transfusion especially in patients who are expected to have a high probability of PBT, such as females and those with a low preoperative hemoglobin level and history of neoadjuvant chemotherapy.

Keywords: Blood transfusion; Cystectomy; Survival; Urinary bladder neoplasms.

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Conflict of interest statement

CONFLICTS OF INTEREST: The authors have nothing to disclose.

Figures

Fig. 1
Fig. 1. Kaplan-Meier curves for overall survival (A) and cancer-specific survival (B) in the entire study cohort according to the administration of perioperative blood transfusion (PBT).
Fig. 2
Fig. 2. Kaplan-Meier curves for overall survival in patients receiving perioperative blood transfusion according to transfused units of packed red blood cells. PBT, perioperative blood transfusion.
See this image and copyright information in PMC

References

    1. Corwin HL, Gettinger A, Pearl RG, Fink MP, Levy MM, Abraham E, et al. The CRIT Study: Anemia and blood transfusion in the critically ill: current clinical practice in the United States. Crit Care Med. 2004;32:39–52. - PubMed
    1. Vincent JL, Baron JF, Reinhart K, Gattinoni L, Thijs L, Webb A, et al. Anemia and blood transfusion in critically ill patients. JAMA. 2002;288:1499–1507. - PubMed
    1. Amato A, Pescatori M. Perioperative blood transfusions for the recurrence of colorectal cancer. Cochrane Database Syst Rev. 2006;(1):CD005033. - PMC - PubMed
    1. Kneuertz PJ, Patel SH, Chu CK, Maithel SK, Sarmiento JM, Delman KA, et al. Effects of perioperative red blood cell transfusion on disease recurrence and survival after pancreaticoduodenectomy for ductal adenocarcinoma. Ann Surg Oncol. 2011;18:1327–1334. - PubMed
    1. Acheson AG, Brookes MJ, Spahn DR. Effects of allogeneic red blood cell transfusions on clinical outcomes in patients undergoing colorectal cancer surgery: a systematic review and metaanalysis. Ann Surg. 2012;256:235–244. - PubMed

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