Abstract：
OBJECTIVE: 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.
METHODS: 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.
RESULTS: 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).
CONCLUSIONS: Perioperative blood transfusion is an independent risk factor that increases tumor recurrence among patients treated with nephrectomy for renal cancer.
METHODS: 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.
RESULTS: 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).
CONCLUSIONS: Perioperative blood transfusion is an independent risk factor that increases tumor recurrence among patients treated with nephrectomy for renal cancer.
摘要：
目的：一些研究报道，输血与肿瘤手术后生存率下降有关。对于肾癌，输血的效果仍然存在争议。这项研究的目的是确定肿瘤肾切除术后输血对整体，局部或局部晚期肾癌回顾性队列中的特异性和无复发生存期.
方法：我们在2000年1月至2016年12月期间对所有接受手术治疗的局部或局部晚期肾癌患者进行了单中心回顾性分析。我们比较了两组之间的总体和特异性生存率以及无复发生存率：患者输血和未输血。人口统计,手术和肿瘤的特点进行了比较。使用单变量Cox回归和多变量Cox比例回归检验进行生存分析。
结果：我们在本研究中纳入了382例患者：320例（83.8%）未输血，62例（16.2%）输血。输血患者明显年龄较大（P=0.001），术前血红蛋白水平较低（P=0.008）。两组之间的手术和肿瘤特征也不同。在单变量分析中，我们发现输血与较低的总生存率相关（P<0.001），特异性生存率（P<0.001），无复发生存率(P<0.001)。在多变量分析中，我们发现输血与总生存率无关,或特定的生存，但与较低的无复发生存率相关(HR:1.967,CI95%[1.024-3.780],P=0.042)。
结论：围手术期输血是增加肾癌肾切除术患者肿瘤复发的独立危险因素。
方法：我们在2000年1月至2016年12月期间对所有接受手术治疗的局部或局部晚期肾癌患者进行了单中心回顾性分析。我们比较了两组之间的总体和特异性生存率以及无复发生存率：患者输血和未输血。人口统计,手术和肿瘤的特点进行了比较。使用单变量Cox回归和多变量Cox比例回归检验进行生存分析。
结果：我们在本研究中纳入了382例患者：320例（83.8%）未输血，62例（16.2%）输血。输血患者明显年龄较大（P=0.001），术前血红蛋白水平较低（P=0.008）。两组之间的手术和肿瘤特征也不同。在单变量分析中，我们发现输血与较低的总生存率相关（P<0.001），特异性生存率（P<0.001），无复发生存率(P<0.001)。在多变量分析中，我们发现输血与总生存率无关,或特定的生存，但与较低的无复发生存率相关(HR:1.967,CI95%[1.024-3.780],P=0.042)。
结论：围手术期输血是增加肾癌肾切除术患者肿瘤复发的独立危险因素。
