Impact of Perioperative Allogenic Blood Transfusion on Survival After Radical Nephroureterectomy for Upper Tract Urothelial Carcinoma
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Impact of Perioperative Allogenic Blood Transfusion on Survival After Radical Nephroureterectomy for Upper Tract Urothelial Carcinoma. / Rink, Michael; Soave, Armin; Dahlem, Roland; Aziz, Atiqullah; Al-Sayed, Fahmy; Peine, Sven; Engel, Oliver; Kluth, Luis A; Stenzl, Arnulf; Burger, Maximilian; Shariat, Shahrokh F; Fisch, Margit; Fritsche, Hans-Martin; Gakis, Georgios.
in: CLIN GENITOURIN CANC, Jahrgang 14, Nr. 1, 20.10.2015, S. 96-104.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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T1 - Impact of Perioperative Allogenic Blood Transfusion on Survival After Radical Nephroureterectomy for Upper Tract Urothelial Carcinoma
AU - Rink, Michael
AU - Soave, Armin
AU - Dahlem, Roland
AU - Aziz, Atiqullah
AU - Al-Sayed, Fahmy
AU - Peine, Sven
AU - Engel, Oliver
AU - Kluth, Luis A
AU - Stenzl, Arnulf
AU - Burger, Maximilian
AU - Shariat, Shahrokh F
AU - Fisch, Margit
AU - Fritsche, Hans-Martin
AU - Gakis, Georgios
N1 - Copyright © 2015 Elsevier Inc. All rights reserved.
PY - 2015/10/20
Y1 - 2015/10/20
N2 - BACKGROUND: Preoperative anemia is an independent predictor for unfavorable outcomes in patients with upper tract urothelial carcinoma (UTUC) who undergo radical nephroureterectomy (RNU). The effect of perioperative blood transfusion (PBT) on survival, however, has been insufficiently investigated. We investigated the impact of PBT on the outcomes of patients UTUC treated with RNU.PATIENTS AND METHODS: We analyzed the data from 285 patients with UTUC who had undergone RNU at 3 German academic institutions. PBT administration was analyzed as a dichotomous variable (administered vs. not administered) and the number of PBT units as a continuous and categorical variable (0 vs. ≤ 2 vs. > 2). Cox regression models were used to analyze the impact of PBT on disease recurrence and survival.RESULTS: A total of 81 patients (28.4%) had received a PBT with a median number of 2 U (interquartile range, 2-4). The administration of PBT was associated with advanced tumor stage, higher tumor grade, and preoperative anemia (P ≤ .049 for all). At a mean follow-up of 52 months, PBT and an increasing number of PBT units were significantly associated with inferior overall survival (P ≤ .025). On multivariable analyses adjusted for established UTUC outcome prognosticators, PBT was significantly associated with inferior overall survival (hazard ratio, 1.6; 95% confidence interval, 1.055-2.428; P = .027).CONCLUSION: PBT is an independent risk factor for worse overall survival in patients with UTUC treated with RNU. Continued efforts are warranted to optimize patients' preoperative hemoglobin level, surgical accuracy, and anesthetic management of RNU to reduce the necessity for PBTs.
AB - BACKGROUND: Preoperative anemia is an independent predictor for unfavorable outcomes in patients with upper tract urothelial carcinoma (UTUC) who undergo radical nephroureterectomy (RNU). The effect of perioperative blood transfusion (PBT) on survival, however, has been insufficiently investigated. We investigated the impact of PBT on the outcomes of patients UTUC treated with RNU.PATIENTS AND METHODS: We analyzed the data from 285 patients with UTUC who had undergone RNU at 3 German academic institutions. PBT administration was analyzed as a dichotomous variable (administered vs. not administered) and the number of PBT units as a continuous and categorical variable (0 vs. ≤ 2 vs. > 2). Cox regression models were used to analyze the impact of PBT on disease recurrence and survival.RESULTS: A total of 81 patients (28.4%) had received a PBT with a median number of 2 U (interquartile range, 2-4). The administration of PBT was associated with advanced tumor stage, higher tumor grade, and preoperative anemia (P ≤ .049 for all). At a mean follow-up of 52 months, PBT and an increasing number of PBT units were significantly associated with inferior overall survival (P ≤ .025). On multivariable analyses adjusted for established UTUC outcome prognosticators, PBT was significantly associated with inferior overall survival (hazard ratio, 1.6; 95% confidence interval, 1.055-2.428; P = .027).CONCLUSION: PBT is an independent risk factor for worse overall survival in patients with UTUC treated with RNU. Continued efforts are warranted to optimize patients' preoperative hemoglobin level, surgical accuracy, and anesthetic management of RNU to reduce the necessity for PBTs.
U2 - 10.1016/j.clgc.2015.10.003
DO - 10.1016/j.clgc.2015.10.003
M3 - SCORING: Journal article
C2 - 26506908
VL - 14
SP - 96
EP - 104
JO - CLIN GENITOURIN CANC
JF - CLIN GENITOURIN CANC
SN - 1558-7673
IS - 1
ER -
