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Effect of blood transfusions on oncological outcomes of surgically treated localized renal cell carcinoma.

Publication ,  Journal Article
Tsivian, M; Abern, MR; Tsivian, E; Sze, C; Jibara, G; Rampersaud, EN; Polascik, TJ
Published in: Urol Oncol
August 2018

OBJECTIVE: To assess the associations between perioperative allogeneic blood transfusions (ABTs) and recurrence, overall and renal cell carcinoma (RCC)-specific survival in patients undergoing surgical treatment for clinically localized disease. MATERIALS AND METHODS: We performed a retrospective review of 1,056 consecutive patients undergoing surgical treatment (radical or partial nephrectomy) for clinically localized RCC between 2000 to 2010. Demographic (age, race, and sex) clinical (preoperative hemoglobin and hematocrit, type of surgery [partial or radical nephrectomy]), and pathological (T and N stages, RCC histotype, grade) data were compared between patients receiving perioperative (intraoperative or postoperative) blood transfusions and those who are not. Distant and local recurrence-free survival, overall survival, RCC-specific survival were recorded and Kaplan-Meier survival curves as well as multivariable proportional regression models adjusted for clinical and pathological characteristics were produced. RESULTS: On multivariable analyses adjusted for clinical and pathological characteristics, the receipt of ABTs was associated with lower recurrence-free (HR = 1.86, P = 0.002), overall (HR = 1.83, P = 0.016), and RCC-specific survival (HR = 2.12, P = 0.031). The negative effect of ABTs was apparent for distant (HR = 2.24, P<0.001) but not local recurrences (HR = 0.78, P = 0.643). Limitations include retrospective nature and lack of uniform criteria for blood transfusion during the study period. CONCLUSIONS: In this study, perioperative ABTs were independently associated with worse oncological outcomes in patients with clinically localized RCC. Receipt of ABT was associated with roughly a 2-fold increase in the hazard of metastatic progression, all-cause and RCC-specific mortality. Further research is needed on the mechanisms of transfusion-induced immunomodulation, alternative transfusion protocols and methods for autologous blood transfusion and recovery.

Duke Scholars

Published In

Urol Oncol

DOI

EISSN

1873-2496

Publication Date

August 2018

Volume

36

Issue

8

Start / End Page

362.e1 / 362.e7

Location

United States

Related Subject Headings

  • Urology & Nephrology
  • Treatment Outcome
  • Survival Rate
  • Retrospective Studies
  • Middle Aged
  • Male
  • Humans
  • Female
  • Carcinoma, Renal Cell
  • Blood Transfusion
 

Citation

APA
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Tsivian, M., Abern, M. R., Tsivian, E., Sze, C., Jibara, G., Rampersaud, E. N., & Polascik, T. J. (2018). Effect of blood transfusions on oncological outcomes of surgically treated localized renal cell carcinoma. Urol Oncol, 36(8), 362.e1-362.e7. https://doi.org/10.1016/j.urolonc.2018.04.014
Tsivian, Matvey, Michael R. Abern, Efrat Tsivian, Christina Sze, Ghalib Jibara, Edward N. Rampersaud, and Thomas J. Polascik. “Effect of blood transfusions on oncological outcomes of surgically treated localized renal cell carcinoma.Urol Oncol 36, no. 8 (August 2018): 362.e1-362.e7. https://doi.org/10.1016/j.urolonc.2018.04.014.
Tsivian M, Abern MR, Tsivian E, Sze C, Jibara G, Rampersaud EN, et al. Effect of blood transfusions on oncological outcomes of surgically treated localized renal cell carcinoma. Urol Oncol. 2018 Aug;36(8):362.e1-362.e7.
Tsivian, Matvey, et al. “Effect of blood transfusions on oncological outcomes of surgically treated localized renal cell carcinoma.Urol Oncol, vol. 36, no. 8, Aug. 2018, pp. 362.e1-362.e7. Pubmed, doi:10.1016/j.urolonc.2018.04.014.
Tsivian M, Abern MR, Tsivian E, Sze C, Jibara G, Rampersaud EN, Polascik TJ. Effect of blood transfusions on oncological outcomes of surgically treated localized renal cell carcinoma. Urol Oncol. 2018 Aug;36(8):362.e1-362.e7.
Journal cover image

Published In

Urol Oncol

DOI

EISSN

1873-2496

Publication Date

August 2018

Volume

36

Issue

8

Start / End Page

362.e1 / 362.e7

Location

United States

Related Subject Headings

  • Urology & Nephrology
  • Treatment Outcome
  • Survival Rate
  • Retrospective Studies
  • Middle Aged
  • Male
  • Humans
  • Female
  • Carcinoma, Renal Cell
  • Blood Transfusion