To evaluate the effect of leukoreduced-only perioperative blood transfusion (PBT) and corresponding survival outcomes in a radical cystectomy (RC) cohort of patients.
We analyzed data from 1,026 patients who underwent RC at our institution. PBT was defined as transfusion in the intraoperative or within the postoperative hospitalization period. Multivariable Cox proportional hazards analyses (MVA) were performed to measure the association between PBT, patient variables, and 3 primary endpoints: recurrence free survival (RFS), disease specific survival (DSS), and overall survival (OS). Kaplan-Meier (KM) curves estimated survival times and were compared with log-rank.
Overall, 33.2% (341/1026) of patients received leukoreduced PBT. Median follow-up was 27.5 months. Transfused patients were more likely to be female, had higher estimated blood loss (EBL), lower preoperative hemoglobin, more likely to have received neoadjuvant chemotherapy (NAC) or undergone a continent urinary diversion. Those with higher pathologic tumor and nodal stage were observed more frequently in patients who received PBT. On MVA, PBT was not associated with worse RFS, DSS, and OS (all, p > 0.05). KM curves did not show any significant differences (all, p > 0.05) between the transfused and non-transfused groups. In addition, no differences were found in regards to timing of transfusion, i.e.: intraoperative vs. postoperative, in distinct analysis.
No significant association was found between leukoreduced-PBT and worse survival outcomes at short term follow up in a contemporary cohort of cystectomy patients. Prospective long-term follow up is warranted.
Urology. 2016 Dec 20 [Epub ahead of print]
Juan J Chipollini, Dominic H Tang, Sephalie Y Patel, Rosemarie E Garcia-Getting, Scott M Gilbert, Julio M Pow-Sang, Wade J Sexton, Philippe E Spiess, Michael A Poch
Department of Genitourinary Oncology, Moffitt Cancer Center, Tampa, FL., Department of Anesthesiology, Moffitt Cancer Center, Tampa, FL., Department of Genitourinary Oncology, Moffitt Cancer Center, Tampa, FL. Electronic address: .