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Systematic Review and Meta-Analysis on the Role of Perioperative Blood Transfusion in Patients Undergoing Radical Cystectomy for Urothelial Carcinoma.
Kochergin, Maxim; Fahmy, Omar; Esken, Lisa; Goetze, Thorsten; Xylinas, Evanguelos; Stief, Christian G; Gakis, Georgios.
Afiliación
  • Kochergin M; Department of Urology and Neurourology, BG Unfallkrankenhaus Berlin, Berlin, Germany.
  • Fahmy O; Department of Urology, Universiti Putra Malaysia (UPM), Selangor, Malaysia.
  • Esken L; Department of Urology and Pediatric Urology, Nordwest Hospital, Frankfurt am Main, Germany.
  • Goetze T; Institute of Clinical Cancer Research, Nordwest Hospital, Frankfurt am Main, Germany.
  • Xylinas E; Department of Urology, Cochin Hospital, APHP, Paris Descartes University, Paris, France.
  • Stief CG; Department of Urology, University Hospital Ludwig-Maximilians-University, Munich, Germany.
  • Gakis G; Department of Urology, University Hospital Würzburg, Würzburg, Germany.
Bladder Cancer ; 8(3): 315-327, 2022.
Article en En | MEDLINE | ID: mdl-38993684
ABSTRACT

BACKGROUND:

Radical cystectomy (RC) is the standard of care in patients with muscle-invasive bladder cancer. The impact of perioperative red blood cell (RBC) transfusion on oncological outcomes after RC is not clearly established as the existing publications show conflicting results.

OBJECTIVES:

The aim of this systematic review and meta-analysis was to investigate the prognostic role of perioperative RBC transfusion on oncological outcomes after RC.

METHODS:

Systematic online search on PubMed was conducted, based on PRISMA criteria for publications reporting on RBC transfusion during RC. Publications with the following criteria were included (I) reported data on perioperative blood transfusion; (II) Reported Hazard ratio (HR) and 95% -confidence interval (CI) for the impact of transfusion on survival outcomes. Primary outcome was the impact of perioperative RBC transfusion on recurrence-free survival (RFS), cancer-specific survival (CSS) and overall survival (OS). Risk of bias assessment was performed using Newcastle-Ottawa Scale. Statistical analysis was performed using Revman 5.4 software.

RESULTS:

From 27 primarily identified publications, 19 eligible articles including 22897 patients were selected. Perioperative RBC transfusion showed no impact on RFS (Z = 1.34; p = 0,18) and significant negative impact on CSS (Z = 2.67; p = 0.008) and OS (Z = 3.22; p = 0.001). Intraoperative RBC transfusion showed no impact on RFS (Z = 0.58; p = 0.56) and CSS (Z = 1.06; p = 0.29) and OS (Z = 1.47; p = 0.14).Postoperative RBC transfusion showed non-significant trend towards improved RFS (Z = 1.89; p = 0.06) and no impact on CSS (Z = 1.56; p = 0.12) and OS (Z = 0.53 p = 0.60).

CONCLUSION:

In this meta-analysis, we found perioperative blood transfusion to be a significant predictor only for worse CSS and OS but not for RFS. This effect may be determined by differences in tumor stages and patient comorbidities for which this meta-analysis cannot control due to lack of respective raw data.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Bladder Cancer Año: 2022 Tipo del documento: Article País de afiliación: Alemania Pais de publicación: Países Bajos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Bladder Cancer Año: 2022 Tipo del documento: Article País de afiliación: Alemania Pais de publicación: Países Bajos