Gierth, M. and Aziz, A. and Fritsche, H. M. and Burger, M. and Otto, W. and Zeman, F. and Pawlik, M. T. and Hansen, E. and May, M. and Denzinger, S. (2014) The effect of intra- and postoperative allogenic blood transfusion on patients' survival undergoing radical cystectomy for urothelial carcinoma of the bladder. WORLD JOURNAL OF UROLOGY, 32 (6). pp. 1447-1453. ISSN 0724-4983, 1433-8726
Full text not available from this repository. (Request a copy)Abstract
Radical cystectomy (RC) can be associated with significant blood loss. Allogenic blood transfusion (ABT) may alter disease outcome because of a theoretical immunomodulatory effect. We evaluated the effects of ABT on overall survival (OS) and progression-free survival (PFS) of patients undergoing RC for urothelial carcinoma of the bladder (UCB). This is a retrospective single-center study of 350 consecutive patients of a university health center with a median follow-up of 70.1 month. All patients underwent RC and pelvic lymph node dissection. The effect of ABT on OS and PFS was analyzed using univariable and multivariable Cox proportional hazards models. The overall ABT rate was 63 % (n = 219), with intraoperative blood transfusion and postoperative blood transfusion being performed in 183 patients (52 %) and 99 patients (28 %), respectively. Preoperative anemia was detected in 156 patients (45 %) with median estimated blood loss of 800 ml (IQR: 500-1,200). ABT was associated with significant decrease of OS and PFS in multivariable analyses (p < 0.001), whereas patients' prognosis worsened the more packed red blood cells (PRBC) were transfused (p < 0.001). The study is limited in part due to its retrospective design. We found that ABT and the number of PRBC transfused are associated with poor prognosis for UCB patients undergoing RC, whereas preoperative anemia had no influence on survival. This emphasizes the importance of surgeon's awareness for a strict indication for ABT. A prospective study will be necessary to evaluate the independent risks associated with ABT during surgical treatments.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | INTRAOPERATIVE AUTOTRANSFUSION; PROGNOSTIC-SIGNIFICANCE; RISK-FACTORS; CANCER; SURGERY; VALIDATION; RECURRENCE; MORTALITY; OUTCOMES; Urothelial carcinoma; Cystectomy; Blood; Transfusion |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Urologie Medicine > Zentren des Universitätsklinikums Regensburg > Zentrum für Klinische Studien |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 07 Aug 2019 11:57 |
| Last Modified: | 07 Aug 2019 11:57 |
| URI: | https://pred.uni-regensburg.de/id/eprint/9152 |
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