Association of perioperative blood transfusion with oncologic outcomes after radical nephroureterectomy for upper tract urothelial carcinoma

M. Rieken, T. Schubert, E. Xylinas, L. Kluth, M. Rouprêt, Q. D. Trinh, R. K. Lee, B. Al Hussein Al Awamlh, H. Fajkovic, G. Novara, Vitaly Margulis, Yair Lotan, J. I. Martinez-Salamanca, K. Matsumoto, C. Seitz, M. Remzi, P. I. Karakiewicz, D. S. Scherr, A. Briganti, A. BachmannS. F. Shariat

Research output: Contribution to journalArticle

14 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)1693-1699
Number of pages7
JournalEuropean Journal of Surgical Oncology
Volume40
Issue number12
DOIs
StatePublished - Dec 1 2014

Keywords

  • Blood transfusion
  • Disease recurrence
  • Radical nephroureterectomy
  • Surgery outcomes
  • Upper tract urothelial carcinoma

ASJC Scopus subject areas

  • Surgery
  • Oncology

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    Rieken, M., Schubert, T., Xylinas, E., Kluth, L., Rouprêt, M., Trinh, Q. D., Lee, R. K., Al Hussein Al Awamlh, B., Fajkovic, H., Novara, G., Margulis, V., Lotan, Y., Martinez-Salamanca, J. I., Matsumoto, K., Seitz, C., Remzi, M., Karakiewicz, P. I., Scherr, D. S., Briganti, A., ... Shariat, S. F. (2014). Association of perioperative blood transfusion with oncologic outcomes after radical nephroureterectomy for upper tract urothelial carcinoma. European Journal of Surgical Oncology, 40(12), 1693-1699. https://doi.org/10.1016/j.ejso.2014.03.018