Timing of blood transfusion and oncologic outcomes in patients treated with radical nephroureterectomy for upper tract urothelial carcinoma

Aditya Bagrodia, Samuel Kaffenberger, Andrew Winer, Katie Murray, Michael Vacchio, Junting Zheng, Irina Ostrovnaya, Bernard H. Bochner, Guido Dalbagni, Eugene K. Cha, Jonathan A. Coleman

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Purpose: To evaluate the impact of timing of blood transfusion in patients with upper tract urothelial carcinoma (UTUC) treated with radical nephroureterectomy (RNU). Methods: Outcomes of consecutive patients with UTUC treated with RNU were analyzed. Clinicopathologic factors were compared using Fisher’s exact test or the Wilcoxon rank-sum test between patients who received any transfusion and no transfusion, and between patients receiving intraoperative transfusion only and patients receiving no transfusion. Cancer-specific and overall survival were estimated and multivariable analyses were performed to assess the impact of timing of transfusion on clinical outcomes. Results: Among 402 patients included in this study, 71 (17.6%) patients received a transfusion at any point and 27 (6.7%) patients received an intraoperative blood transfusion. Transfusion at any time, patient comorbidity, high grade, advanced stage, positive surgical margins, low preoperative hemoglobin, longer operative duration, and increased blood loss were significantly associated with cancer-specific survival (DSS) on univariable analysis (HR 1.85, 95% CI 1.20–2.85, p < 0.005). In the multivariable analysis, transfusion at any point was not a prognostic factor (HR 1.00, 95% CI 0.60–1.68, p = 0.99). When examining intraoperatively transfusion only, transfusion was significantly associated with DSS (HR 1.91, 95% CI 1.01–3.59, p = 0.045) but no longer significant in multivariable analysis (HR 0.72, 95% CI 0.32–1.65, p = 0.440). Conclusions: Our study indicates that the administration of blood transfusion either intraoperatively or postoperatively is not associated with clinical or oncological outcomes in patients with upper tract urothelial carcinoma when adjusted for other factors in multivariable analysis. Further study is required.

Original languageEnglish (US)
Pages (from-to)645-653
Number of pages9
JournalWorld journal of urology
Volume36
Issue number4
DOIs
StatePublished - Apr 1 2018

Keywords

  • Intraoperative blood transfusion
  • Surgery
  • Transfusion
  • UTTCC
  • Urothelial carcinoma

ASJC Scopus subject areas

  • Urology

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