J Cancer 2016; 7(8):965-972. doi:10.7150/jca.15073

Research Paper

Association between Perioperative Blood Transfusion and Oncologic Outcomes after Curative Surgery for Renal Cell Carcinoma

Yong Hyun Park1, Yong-June Kim2, Seok Ho Kang3, Hyeon Hoe Kim4, Seok-Soo Byun5, Ji Youl Lee1, Sung-Hoo Hong1✉

1. Department of Urology, Seoul St. Mary's Hospital, The Catholic University, Seoul, Korea
2. Department of Urology, Chungbuk National University College of Medicine, Cheongju, Korea
3. Department of Urology, Korea University School of Medicine, Seoul, Korea
4. Department of Urology, Seoul National University College of Medicine, Seoul, Korea
5. Department of Urology, Seoul National University Bundang Hospital, Seongnam, Korea

Abstract

Purpose: We aimed to elucidate the association between perioperative blood transfusion (PBT) and the prognosis of patients undergoing curative surgery for renal cell carcinoma (RCC).

Methods: In all, 3,832 patients with RCC who had undergone curative surgery were included in this study from a multicenter database. PBT was defined as the transfusion of packed red blood cells within seven days before surgery, during surgery, or within the postoperative hospitalization period. The association of PBT with oncologic outcomes was evaluated using univariate and multivariate Cox regression analyses, and regression adjustment with propensity score matching.

Results: Overall, 11.7% (447/3,832) of patients received PBT. Patients receiving PBT were significantly older at diagnosis, and had lower BMI, higher comorbidities, worse ECOG performance status, and more initial symptoms. Moreover, higher pathologic TNM stage, larger mass size, higher nuclear grade, more sarcomatoid differentiation, and more tumor necrosis were all observed more frequently in patients who received PBT. In univariate analysis, relapse-free survival, cancer-specific survival, and overall survival rates were worse in patients who received PBT; however, these factors became insignificant in the matched pairs after propensity score matching. On multivariate Cox regression analysis and regression adjustment with propensity score matching, significant prognostic effects of PBT on disease relapse, cancer-specific mortality, and all-cause mortality were not observed.

Conclusions: This multicenter database analysis demonstrates no significant prognostic association between PBT and oncologic outcomes in patients with RCC.

Keywords: renal cell carcinoma, perioperative blood transfusion, prognosis

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How to cite this article:
Park YH, Kim YJ, Kang SH, Kim HH, Byun SS, Lee JY, Hong SH. Association between Perioperative Blood Transfusion and Oncologic Outcomes after Curative Surgery for Renal Cell Carcinoma. J Cancer 2016; 7(8):965-972. doi:10.7150/jca.15073. Available from http://www.jcancer.org/v07p0965.htm