Perioperative Blood Transfusion Linked to Worse Survival in Renal Cell Carcinoma

11/10/17

Receipt of perioperative blood transfusion after surgery for renal cell carcinoma is associated with a higher risk of tumor recurrence, progression, and death, according to a recent study.

Results of the study were published in Urologic Oncology (online October 6, 2017; doi:10.1016/j.urolonc.2017.09.006).

Prior research suggests that perioperative blood transfusion may have a strong correlation with worse oncological outcomes following nephrectomy for renal cell carcinoma. However, data to support such a claim have been inconsistent.

Yasmin Abu-Ghanem, MD, Sheba Medical Center (Israel), and colleagues conducted a retrospective study to examine the effects of perioperative blood transfusions on the prognoses of patients who underwent radical nephrectomy or partial nephrectomy for renal cell carcinoma between 1987 to 2013. A total of 1159 patients were included in the study, 198 of whom (17.1%) received a perioperative blood transfusion.

Authors of the study noted that receipt of a perioperative blood transfusion was associated with a symptomatic presentation and a higher rate of adverse pathological features, including large tumors, high nuclear grade, presence of necrosis, and capsular invasion. Patients in this cohort also were more likely to have undergone an open surgical procedure.

Results of the study showed that receipt of a perioperative blood transfusion was associated with a substantially worse 5-year relapse-free survival (81%) and metastatic-free survival (79%) compared with patients who did not receive a transfusion (92% and 93%, respectively). Furthermore, receiving a transfusion was associated with a worse 5-year cancer-specific survival (85%) and overall survival (73%) compared with those who did not receive a transfusion (95% and 81%, respectively).

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Multivariate subgroup analyses showed that patients who underwent a partial nephrectomy had worse outcomes if they received a transfusion compared with those who did not receive one (5-year relapse-free survival, 81% vs 90%; cancer-specific survival, 89% vs 97%; overall survival, 82% vs 92%, respectively).

“Although these findings require further validation, continued efforts to minimize the use of blood products in patients with renal cell carcinoma are essential,” said Dr Abu-Ghanem in a statement (November 5, 2017).—Zachary Bessette