Effect of blood product transfusion on the prognosis of patients undergoing hepatectomy for hepatocellular carcinoma : a propensity score matching analysis
© 2023. Japanese Society of Gastroenterology..
BACKGROUND: Hepatectomy, the most common treatment for hepatocellular carcinoma, is associated with greater intraoperative blood loss than is resection of other malignancies. The effect of blood product transfusion (red blood cell [RBC], platelet, fresh frozen plasma [FFP], 5 and 25% albumin) on prognosis remains unclear. This study examined effects of blood product transfusion on prognoses of patients who underwent hepatectomy for hepatocellular carcinoma.
METHODS: We included 2015 patients with pathologically confirmed hepatocellular carcinoma who underwent hepatectomy at our institution during 1990-2019. Patients (n = 534) who underwent repeat hepatectomy, non-curative hepatectomy, those with synchronous cancer in other organs, those who died within 1 month of surgery, and those with missing data were excluded. Finally, 1481 patients (1142 males, 339 females; median age: 68 years) with curability A or B were included.
RESULTS: Intraoperative blood loss (> 500 mL) was an independent predictor of RBC transfusion (odds ratio, 8.482; P < 0.001). All transfusion groups had poorer recurrence-free survival (RFS) and overall survival (OS) than non-transfusion groups. After propensity score matching, the 5 year RFS rate was 13.4 and 16.3% in the RBC and no-RBC groups, respectively (P = 0.020). The RBC group had a significantly lower 5 year OS rate than the no-RBC group (42.1 vs. 48.8%, respectively; P = 0.035) and the FFP group (57.0%) than the no-FFP group (63.9%) (p = 0.047). No significant between-subgroup differences were found for other blood transfusion types.
CONCLUSIONS: RBC transfusion promotes hepatocellular carcinoma recurrence and RBC/FFP transfusions reduced long-term survival and RFS and OS in patients who underwent radical liver resection of HCC.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:58 |
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| Enthalten in: |
Journal of gastroenterology - 58(2023), 2 vom: 02. Feb., Seite 171-181 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Nakayama, Hisashi [VerfasserIn] |
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| Links: |
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| Themen: |
Blood transfusion |
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| Anmerkungen: |
Date Completed 27.01.2023 Date Revised 22.02.2023 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1007/s00535-022-01946-9 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM351035281 |
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| 100 | 1 | |a Nakayama, Hisashi |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Effect of blood product transfusion on the prognosis of patients undergoing hepatectomy for hepatocellular carcinoma |b a propensity score matching analysis |
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| 500 | |a Date Revised 22.02.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2023. Japanese Society of Gastroenterology. | ||
| 520 | |a BACKGROUND: Hepatectomy, the most common treatment for hepatocellular carcinoma, is associated with greater intraoperative blood loss than is resection of other malignancies. The effect of blood product transfusion (red blood cell [RBC], platelet, fresh frozen plasma [FFP], 5 and 25% albumin) on prognosis remains unclear. This study examined effects of blood product transfusion on prognoses of patients who underwent hepatectomy for hepatocellular carcinoma | ||
| 520 | |a METHODS: We included 2015 patients with pathologically confirmed hepatocellular carcinoma who underwent hepatectomy at our institution during 1990-2019. Patients (n = 534) who underwent repeat hepatectomy, non-curative hepatectomy, those with synchronous cancer in other organs, those who died within 1 month of surgery, and those with missing data were excluded. Finally, 1481 patients (1142 males, 339 females; median age: 68 years) with curability A or B were included | ||
| 520 | |a RESULTS: Intraoperative blood loss (> 500 mL) was an independent predictor of RBC transfusion (odds ratio, 8.482; P < 0.001). All transfusion groups had poorer recurrence-free survival (RFS) and overall survival (OS) than non-transfusion groups. After propensity score matching, the 5 year RFS rate was 13.4 and 16.3% in the RBC and no-RBC groups, respectively (P = 0.020). The RBC group had a significantly lower 5 year OS rate than the no-RBC group (42.1 vs. 48.8%, respectively; P = 0.035) and the FFP group (57.0%) than the no-FFP group (63.9%) (p = 0.047). No significant between-subgroup differences were found for other blood transfusion types | ||
| 520 | |a CONCLUSIONS: RBC transfusion promotes hepatocellular carcinoma recurrence and RBC/FFP transfusions reduced long-term survival and RFS and OS in patients who underwent radical liver resection of HCC | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Blood transfusion | |
| 650 | 4 | |a Hepatectomy | |
| 650 | 4 | |a Hepatocellular carcinoma | |
| 700 | 1 | |a Okamura, Yukiyasu |e verfasserin |4 aut | |
| 700 | 1 | |a Higaki, Tokio |e verfasserin |4 aut | |
| 700 | 1 | |a Moriguchi, Masamichi |e verfasserin |4 aut | |
| 700 | 1 | |a Takayama, Tadatoshi |e verfasserin |4 aut | |
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