Perioperative Blood Transfusion Is Associated with Worse Survival in Patients Undergoing Radical Cystectomy after Neoadjuvant Chemotherapy for Muscle-Invasive Bladder Cancer
Abstrak
<b>Objectives:</b> Perioperative blood transfusion (PBT) has been associated with worse survival after radical cystectomy (RC) in patients with muscle-invasive bladder cancer (MIBC). Here, we evaluated the association between PBT and survival after RC that was preceded by neoadjuvant chemotherapy (NAC). <b>Methods:</b> A retrospective analysis was performed on 949 patients with cT2-4aN0M0 bladder cancer who received NAC prior to RC between 2000 and 2013 at 19 centers. Kaplan–Meier estimates of overall survival (OS) were made. Presumed risk factors for OS were analyzed using Cox regression analysis. PBT was defined by the administration of any packed red blood cells during surgery or during the post-operative hospital stay. <b>Results:</b> A transfusion was given to 608 patients (64%). Transfused patients were more likely to have adverse clinical and pathologic parameters, including clinical stage and performance status. Transfused patients had worse OS (<i>p</i> = 0.01). On multivariable Cox regression, PBT was found to be independently associated with worse OS (HR 1.53 (95% CI 1.13–2.08), <i>p</i> = 0.007). <b>Conclusions:</b> PBT is common after NAC and RC, which may be linked, in part, to the anemia induced by NAC. PBT was associated with several adverse risk factors that correlate with poor outcomes after NAC and RC, and it was an independent predictor of adverse OS on multivariable analysis. Further study should determine if measures to avoid blood loss can reduce the need for PBT and thereby improve patient outcomes.
Topik & Kata Kunci
Penulis (36)
Tessa Ladner
Anna J. Black
Homayoun Zargar
Jonathan L. Wright
Andrew C. Thorpe
Todd M. Morgan
Jeff M. Holzbeierlein
Michael S. Cookson
Niels-Erik Jacobsen
Adrian S. Fairey
Colin P. N. Dinney
Maria C. Mir
Laura-Maria Krabbe
Jeffrey S. Montgomery
Nikhil Vasdev
Evan Y. Yu
Evanguelos Xylinas
Andrew J. Stephenson
Jay B. Shah
Siamak Daneshmand
Kamran Zargar-Shoshtari
Philippe E. Spiess
Laura S. Mertens
Bas W. G. van Rhijn
Petros Grivas
Wassim Kassouf
Marc A. Dall’Era
Srikala S. Sridhar
Jonathan S. McGrath
Jonathan Aning
Shahrokh F. Shariat
Trinity J. Bivalacqua
Scott A. North
Daniel A. Barocas
Yair Lotan
Peter C. Black
Format Sitasi
Akses Cepat
- Tahun Terbit
- 2024
- Sumber Database
- DOAJ
- DOI
- 10.3390/siuj5030031
- Akses
- Open Access ✓