Intraoperative allogeneic blood transfusion is associated with adverse oncological outcomes in patients with surgically treated non-metastatic clear cell renal cell carcinoma.

Autor: Kang HW; Department of Urology, Chungbuk National University College of Medicine, 1st Chungdae-ro, Seowon-gu, Cheongju, Chungbuk, 28644, South Korea.; Department of Urology, Chungbuk National University Hospital, Cheongju, South Korea., Seo SP; Department of Urology, Chungbuk National University College of Medicine, 1st Chungdae-ro, Seowon-gu, Cheongju, Chungbuk, 28644, South Korea.; Department of Urology, Chungbuk National University Hospital, Cheongju, South Korea., Kim WT; Department of Urology, Chungbuk National University College of Medicine, 1st Chungdae-ro, Seowon-gu, Cheongju, Chungbuk, 28644, South Korea.; Department of Urology, Chungbuk National University Hospital, Cheongju, South Korea., Yun SJ; Department of Urology, Chungbuk National University College of Medicine, 1st Chungdae-ro, Seowon-gu, Cheongju, Chungbuk, 28644, South Korea.; Department of Urology, Chungbuk National University Hospital, Cheongju, South Korea., Lee SC; Department of Urology, Chungbuk National University College of Medicine, 1st Chungdae-ro, Seowon-gu, Cheongju, Chungbuk, 28644, South Korea.; Department of Urology, Chungbuk National University Hospital, Cheongju, South Korea., Kim WJ; Department of Urology, Chungbuk National University College of Medicine, 1st Chungdae-ro, Seowon-gu, Cheongju, Chungbuk, 28644, South Korea.; Department of Urology, Chungbuk National University Hospital, Cheongju, South Korea., Hwang EC; Department of Urology, Chonnam National University Hwasun Hospital, Hwasun-gun, South Korea., Kang SH; Department of Urology, Korea University School of Medicine, Seoul, South Korea., Hong SH; Department of Urology, College of Medicine, The Catholic University of Korea, Seoul, South Korea., Chung J; Department of Urology, National Cancer Center, Goyang, South Korea., Kwon TG; Department of Urology, Kyungpook National University College of Medicine, Daegu, South Korea., Kim HH; Department of Urology, Seoul National University College of Medicine, Seoul, South Korea., Kwak C; Department of Urology, Seoul National University College of Medicine, Seoul, South Korea., Byun SS; Department of Urology, Seoul National University Bundang Hospital, 166, Gumi-ro, Bundang-gu, Seongnam, Kyunggi-do, 463-707, South Korea. ssbyun@snubh.org., Kim YJ; Department of Urology, Chungbuk National University College of Medicine, 1st Chungdae-ro, Seowon-gu, Cheongju, Chungbuk, 28644, South Korea. urokyj@cbnu.ac.kr.; Department of Urology, Chungbuk National University Hospital, Cheongju, South Korea. urokyj@cbnu.ac.kr.
Jazyk: angličtina
Zdroj: International journal of clinical oncology [Int J Clin Oncol] 2020 Aug; Vol. 25 (8), pp. 1551-1561. Date of Electronic Publication: 2020 Jun 05.
DOI: 10.1007/s10147-020-01694-x
Abstrakt: Background: The objective of this study was to provide more definitive information about the prognostic impact of perioperative blood transfusion (PBT) on patients with surgically treated renal cell carcinoma (RCC).
Methods: A database of 4019 patients with clear cell RCC, all of whom underwent radical or partial nephrectomy as primary therapy as part of a multi-institutional Korean collaboration between 1988 and 2015, was analyzed retrospectively. PBT was defined as transfusion of allogeneic red blood cells during surgery or postsurgical period. Receipt of a PBT, as well as the amount and time of blood transfusion (BT), was compared.
Results: Overall, 335 (8.3%) patients received a PBT: 84 received postoperative BT, 202 received intraoperative BT, and 49 received both intraoperative and postoperative BT. Patients receiving a PBT had a poor preoperative immuno-nutritional status, and aggressive tumor characteristics. Multivariate analyses identified PBT as an independent predictor of recurrence-free survival and cancer-specific survival. Prognostic impact of PBT was restricted to those with locally advanced stage (pT3-4), and who underwent radical nephrectomy. Among patients who received a PBT, intraoperative (but not postoperative) BT was a prognostic factor for survival. Among patients who received intraoperative BT, those receiving three or more transfusion units had a significantly worse survival.
Conclusion: Receipt of a PBT was an independent predictor of RFS and CSS in patients with surgically treated RCC, specifically locally advanced disease. Regarding the prognostic impact of timing or dose of PBT on survival, intraoperative BT and ≥ 3 pRBC units were associated with adverse oncological outcomes.
Databáze: MEDLINE
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