Several studies have reported blood transfusion were associated with a decrease of survival after oncological surgery. For kidney cancer, the effect of blood transfusion is still debated. The objective of this study was to determine the effect of blood transfusion after oncological nephrectomy on overall, specific and recurrence-free survival in a retrospective cohort of localized or locally advanced kidney cancer.
We performed a monocentric retrospective analysis of all patients managed by surgery for localized or locally advanced renal cancer between January 2000 and December 2016. We compared overall and specific survival and recurrence-free survival between two groups: patients transfused and not transfused. Demographic, surgical and tumor characteristics were compared. Survival analyses were performed using univariate Cox regression and multivariate Cox proportional regression test.
We included 382 patients in this study: 320 (83.8%) were not transfused and 62 (16.2%) were transfused. Transfused patients were significantly older (P=0.001) and had a lower pre-operative hemoglobin level (P=0.008). Operative and oncological characteristics were also different between both groups. In univariate analysis, we showed that blood transfusion was associated with lower overall survival (P<0.001), specific survival (P<0.001), and recurrence-free survival (P<0.001). In multivariate analysis, we found that blood transfusion was not associated with overall survival, or specific survival, but it was associated with lower recurrence-free survival (HR: 1.967, CI95% [1.024-3.780], P=0.042).
Perioperative blood transfusion is an independent risk factor that increases tumor recurrence among patients treated with nephrectomy for renal cancer.
Progres en urologie : journal de l'Association francaise d'urologie et de la Societe francaise d'urologie. 2022 May 03 [Epub ahead of print]
P Détrée, L Balssa, V Richard, C Francois, J Barkatz, S Bernardini, E Chabannes, G Guichard, A Thiery-Vuillemin, F Kleinclauss, A Frontczak
Department of Urology, Andrology and Renal Transplantation, University Hospital of Besançon, 3, boulevard Fleming, 25000 Besançon, France; University of Franche-Comté, 25000 Besançon, France., Department of Urology, Andrology and Renal Transplantation, University Hospital of Besançon, 3, boulevard Fleming, 25000 Besançon, France., University of Franche-Comté, 25000 Besançon, France; Department of Medical Oncology, University Hospital of Besançon, 25000 Besançon, France; INSERM UMR 1098, 25000 Besançon, France., Department of Urology, Andrology and Renal Transplantation, University Hospital of Besançon, 3, boulevard Fleming, 25000 Besançon, France; University of Franche-Comté, 25000 Besançon, France; Nanomedicine Lab, Imagery and Therapeutics". EA 4662, 25000 Besançon, France., Department of Urology, Andrology and Renal Transplantation, University Hospital of Besançon, 3, boulevard Fleming, 25000 Besançon, France; University of Franche-Comté, 25000 Besançon, France; Nanomedicine Lab, Imagery and Therapeutics". EA 4662, 25000 Besançon, France. Electronic address: .