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Cited 7 time in webofscience Cited 5 time in scopus
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Intraoperative allogeneic blood transfusion is associated with adverse oncological outcomes in patients with surgically treated non-metastatic clear cell renal cell carcinoma

Authors
Kang, Ho WonSeo, Sung PilKim, Won TaeYun, Seok JoongLee, Sang-CheolKim, Wun-JaeHwang, Eu ChangKang, Seok HoHong, Sung-HooChung, JinsooKwon, Tae GyunKim, Hyeon HoeKwak, CheolByun, Seok-SooKim, Yong-JuneThe KORCC (KOrean Renal Cell Carcinoma) Group
Issue Date
Aug-2020
Publisher
SPRINGER JAPAN KK
Keywords
Renal cell carcinoma; Nephrectomy; Transfusion; Prognosis; Survival
Citation
International Journal of Clinical Oncology, v.25, no.8, pp 1551 - 1561
Pages
11
Indexed
SCIE
SCOPUS
Journal Title
International Journal of Clinical Oncology
Volume
25
Number
8
Start Page
1551
End Page
1561
URI
https://scholarworks.korea.ac.kr/kumedicine/handle/2020.sw.kumedicine/28014
DOI
10.1007/s10147-020-01694-x
ISSN
1341-9625
1437-7772
Abstract
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.
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Kang, Seok Ho
Anam Hospital (Department of Urology, Anam Hospital)
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