TY - JOUR
T1 - Association of perioperative blood transfusion with oncologic outcomes after radical nephroureterectomy for upper tract urothelial carcinoma
AU - Rieken, M.
AU - Schubert, T.
AU - Xylinas, E.
AU - Kluth, L.
AU - Rouprêt, M.
AU - Trinh, Q. D.
AU - Lee, R. K.
AU - Al Hussein Al Awamlh, B.
AU - Fajkovic, H.
AU - Novara, G.
AU - Margulis, Vitaly
AU - Lotan, Yair
AU - Martinez-Salamanca, J. I.
AU - Matsumoto, K.
AU - Seitz, C.
AU - Remzi, M.
AU - Karakiewicz, P. I.
AU - Scherr, D. S.
AU - Briganti, A.
AU - Bachmann, A.
AU - Shariat, S. F.
N1 - Publisher Copyright:
© 2014 Elsevier Ltd.
PY - 2014/12/1
Y1 - 2014/12/1
N2 - Background To test the hypothesis that perioperative blood transfusion (PBT)impacts oncologic outcomes of patients treated with radical nephroureterectomy (RNU) for upper tract urothelial carcinoma (UTUC). Methods Retrospective analysis of 2492 patients with UTUC treated at 23 institutions with RNU between 1987 and 2007.Cox regression models addressed the association of PBT with disease recurrence, cancer-specific mortality and any-cause mortality. Results A total of 510 patients (20.5%) patients received PBT. Within a median follow-up of 36 months (Interquartile range: 55 months), 663 (26.6%) patients experienced disease recurrence, 545 patients (21.9%) died of UTUC and 884 (35.5%) patients died from any cause. Patients who received PBT were at significantly higher risk of disease recurrence, cancer-specific mortality and overall mortality than patients not receiving PBT in univariable Cox regression analyses. In multivariable Cox regression analyses that adjusted for the effects of standard clinicopathologic features, PBT did not remain associated with disease recurrence (HR: 1.11; 95% CI 0.92-1.33, p = 0.25), cancer-specific mortality (HR: 1.09; 95% CI 0.89-1.33, p = 0.41) or overall mortality (HR: 1.09; 95% CI 0.93-1.28, p = 0.29). Conclusions In patients undergoing RNU for UTUC, PBT is associated with disease recurrence, cancer-specific survival or overall survival in univariable, but not in multivariable Cox regression analyses.
AB - Background To test the hypothesis that perioperative blood transfusion (PBT)impacts oncologic outcomes of patients treated with radical nephroureterectomy (RNU) for upper tract urothelial carcinoma (UTUC). Methods Retrospective analysis of 2492 patients with UTUC treated at 23 institutions with RNU between 1987 and 2007.Cox regression models addressed the association of PBT with disease recurrence, cancer-specific mortality and any-cause mortality. Results A total of 510 patients (20.5%) patients received PBT. Within a median follow-up of 36 months (Interquartile range: 55 months), 663 (26.6%) patients experienced disease recurrence, 545 patients (21.9%) died of UTUC and 884 (35.5%) patients died from any cause. Patients who received PBT were at significantly higher risk of disease recurrence, cancer-specific mortality and overall mortality than patients not receiving PBT in univariable Cox regression analyses. In multivariable Cox regression analyses that adjusted for the effects of standard clinicopathologic features, PBT did not remain associated with disease recurrence (HR: 1.11; 95% CI 0.92-1.33, p = 0.25), cancer-specific mortality (HR: 1.09; 95% CI 0.89-1.33, p = 0.41) or overall mortality (HR: 1.09; 95% CI 0.93-1.28, p = 0.29). Conclusions In patients undergoing RNU for UTUC, PBT is associated with disease recurrence, cancer-specific survival or overall survival in univariable, but not in multivariable Cox regression analyses.
KW - Blood transfusion
KW - Disease recurrence
KW - Radical nephroureterectomy
KW - Surgery outcomes
KW - Upper tract urothelial carcinoma
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U2 - 10.1016/j.ejso.2014.03.018
DO - 10.1016/j.ejso.2014.03.018
M3 - Article
C2 - 24780094
AN - SCOPUS:84920713746
SN - 0748-7983
VL - 40
SP - 1693
EP - 1699
JO - European Journal of Surgical Oncology
JF - European Journal of Surgical Oncology
IS - 12
ER -