STOCKHOLM, SWEDEN (UroToday.com) - The objective of this multicenter study (on 2 492 patients from 23 institutions) was to test the hypothesis whether perioperative blood transfusion (PBT) impacts oncologic outcomes of patients treated with radical nephroureterectomy (RNU) for upper tract urothelial carcinoma (UTUC). Cox regression models were used to address the association of PBT with disease recurrence, cancer-specific mortality, and any-cause mortality.
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Median follow-up of the study was 36 months. A total of 510 patients (20.5%) received PBT. Total of 663 (26.6%) patients experienced disease recurrence, 545 patients (21.9%) died of UTUC, and 884 (35.5%) patients died from others causes. They reported an actuarial estimate of 5-year recurrence-free survival of 72% and 63% for patients not receiving and receiving PBT, respectively (p=0.001). In regards to cancer-specific survival and overall survival, they reported 5-year actuarial estimate of 76% and 66% for patients not receiving PBT and 67% and 57% for patients receiving PBT, respectively (p < 0.001). In multivariable Cox regression analyses that adjusted for the effects of standard clinicopathologic features, PBT did not remain associated with disease recurrence (HR: 1.11; 95% CI 0.92-1.33, p=0.25), cancer-specific mortality (HR: 1.09; 95% CI 0.89-1.33, p=0.41) or overall mortality (HR: 1.09; 95% CI 0.93-1.28, p=0.29). Furthermore, in subgroup analysis, among patients with organ-confined and non-organ confined UTUC, PBT was not independently associated with disease recurrence, cancer-specific mortality, or overall mortality. The negative effect of PBT on survival in patients with UC of bladder has been previously shown.
From this abstract, one can conclude that perhaps the circumstances leading to PBT are prognosticators of outcome in patients with UTUC, and not PBT itself.
Presented by Malte Rieken at the 29th Annual European Association of Urology (EAU) Congress - April 11 - 15, 2014 - Stockholmsmässan - Stockholm, Sweden
Weill Cornell Medical College, Department of Urology, New York USA
Written by Reza Mehrazin, MD, medical writer for UroToday.com