Blood Transfusion Predicts Worse Outcomes After Nephrectomy for RCC

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Perioperative blood transfusion is associated with increased risks of tumor recurrence, metastatic progression, and cancer-related mortality.
Perioperative blood transfusion is associated with increased risks of tumor recurrence, metastatic progression, and cancer-related mortality.

Perioperative blood transfusion (PBT) is associated with a worse prognosis following nephrectomy for renal cell carcinoma (RCC), according to a new study.

In a study of 1159 RCC patients undergoing nephrectomy (52% partial and 48% radical), receipt of a PBT was associated with a 2.1-, 2.4-, 2.5-, and 2.2-fold increased risk of tumor recurrence, metastatic progression, RCC-related death, and all-cause mortality, respectively, Yasmin Abu-Ghanem, MD, of Sheba Medical Center in Tel Hashomer, Israel, and colleagues reported online ahead of print in Urologic Oncology.

“Although these findings require further validation, continued efforts to minimize the use of blood products in patients with RCC are essential,” the authors concluded.

Of the 1159 patients, 198 (17.1%) received a PBT. The median follow-up was 63.2 months.

The investigators also looked at whether the association between PBT and prognosis remains significant when examined among the 582 patients in the PN group, of whom 87 (14.9%) required PBT. After controlling for patient and tumor-related variables, PBT recipients had a significant 5.9- and 5.8-fold increased risk of metastatic progression and cancer-related death, respectively, compared with patients who did not receive a PBT.

Risk factors for PBT included lower preoperative hemoglobin values, renal mass size, open surgical approach, and capsular invasion.

Reference

Abu-Ghanem Y, Zilberman DE, Dotan Z, et al. Perioperative blood transfusion adversely affects prognosis after nephrectomy for renal cell carcinoma. Urol Oncol 2017; published online ahead of print. doi: 10.1016/j.urolonc.2017.09.006

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