Perioperative blood transfusion does not influence recurrence-free and overall survivals after curative resection for hepatocellular carcinoma: A Propensity Score Matching Analysis

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• 作者：Tian Yang¹ ; ² ; Jun-Hua Lu¹ ; Wan Yee Lau¹ ; ³ ; Tian-Yi Zhang⁴ ; Han Zhang¹ ; Yi-Nan Shen¹ ; Kutaiba Alshebeeb² ; Meng-Chao Wu¹ ; Myron Schwartz² ; ^{myron.schwartz@mountsinai.org" class="auth_mail" title="E-mail the corresponding author} ; Feng Shen¹ ; ^{shenfengdfgd@163.com" class="auth_mail" title="E-mail the corresponding author}
• 关键词：PBT ; Perioperative blood transfusion ; HCC ; Hepatocellular carcinoma ; OS ; Overall survival ; DFS ; Disease-free survival ; HR ; Hazard ratio ; 95% CI ; 95 percent confidence interval ; ECOG ; Eastern Cooperative Oncology Group ; AFP ; Alpha-fetoprotein ; US ; Ultrasonography ; CT ; Computed tomography ; MRI ; Magnetic resonance imaging ; TACE ; Transcatheter arterial chemoembolization ; ASA ; American Society of Anesthesiologists ; AST ; Aspartate aminotransferase ; HBsAg ; Hepatitis B surface antigen ; HCV ; Hepatitis C
• 刊名：Journal of Hepatology
• 出版年：2016
• 出版时间：March 2016
• 年：2016
• 卷：64
• 期：3
• 页码：583-593
• 全文大小：1090 K

文摘

Whether perioperative blood transfusions (PBTs) negatively impact oncologic outcomes after curative resection for HCC remains controversial.

We aimed to identify the independent predictive factors of PBT for curative resection of hepatocellular carcinoma (HCC), and to investigate the impact of PBT on long-term recurrence and survivals after resection.

Methods

Of 1103 patients who underwent curative liver resection for HCC between 1999 and 2010, 285 (25.8%) patients received PBT. Univariable and multivariable regression analyses were used to identify independent predictive factors of PBT. Propensity scores and Cox regression analyses were used to compare the overall survival (OS) and recurrence-free survival (RFS) between patients who did and did not receive PBT.

Results

Multivariable regression analysis revealed that performance status, preoperative hemoglobin, cirrhosis, portal hypertension, tumor rupture, tumor size, macroscopic vascular invasion, and intraoperative blood loss were independent predictive factors of PBT for HCC resection. Propensity score matching analysis created 234 pairs of patients. Before propensity matching, PBT was significantly associated with increased risks of OS (HR: 2.455, 95% CI: 2.077–2.901, p <0.001) and RFS (HR: 2.018, 95% CI: 1.718–2.370, p <0.001) in the entire cohort. After propensity matching, PBT was not significantly associated with increased risks of OS (HR: 1.229, 95% CI: 0.988–1.527, p = 0.063) and RFS (HR: 1.188, 95% CI: 0.960–1.469, p = 0.113). After adjustment for other prognostic variables in the propensity matched cohort, PBT was still found not to be associated with OS and RFS after HCC resection.

Conclusions

The present study identified that PBT did not influence RFS and OS after curative resection of HCC.