Perioperative Blood Transfusion and Prognosis After Surgery for Renal Cancer
For patients undergoing nephrectomy for renal cell carcinoma, perioperative blood transfusion adversely affects their prognosis, according to a study by Yasmin Abu-Ghanem, MD, of Tel Aviv University, Israel, and colleagues published in Urologic Oncology. Reduced recurrence-free survival, cancer-specific survival, and overall survival were reported, as were worse oncologic outcomes in these transfused patients after surgery.
The study focused on the years between 1987 and 2013, when 1159 patients underwent radical (48%) or partial (52%) nephrectomy. Of these patients, nearly 200 (17%) received a perioperative blood transfusion. Among the risk factors for transfusion were lower preoperative hemoglobin, the size of the renal mass, an open surgical approach, and capsular invasion.
Receipt of perioperative blood transfusion was associated with an increased risk of tumor recurrence (2.1-fold), metastatic disease progression (2.4-fold), cancer-specific survival (2.5-fold), and overall survival (2.2-fold). Furthermore, in a subgroup analysis, the link between perioperative blood transfusion and outcomes remained significant, after the investigators controlled for patient- and tumor-related variables with respect to metastatic disease progression, cancer-specific survival, and overall survival.