M Rieken1, T Schubert2, E Xylinas3, L Kluth4, M Rouprêt5, Q-D Trinh6, R K Lee2, B Al Hussein Al Awamlh2, H Fajkovic7, G Novara8, V Margulis9, Y Lotan9, J I Martinez-Salamanca10, K Matsumoto11, C Seitz7, M Remzi12, P I Karakiewicz13, D S Scherr2, A Briganti14, A Bachmann15, S F Shariat16. 1. Department of Urology, Weill Cornell Medical College, New York-Presbyterian Hospital, New York, NY, USA; Department of Urology, University Hospital Basel, Basel, Switzerland. 2. Department of Urology, Weill Cornell Medical College, New York-Presbyterian Hospital, New York, NY, USA. 3. Department of Urology, Weill Cornell Medical College, New York-Presbyterian Hospital, New York, NY, USA; Department of Urology, Cochin Hospital, APHP, Paris Descartes University, Paris, France. 4. Department of Urology, Weill Cornell Medical College, New York-Presbyterian Hospital, New York, NY, USA; Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. 5. Department of Urology, AP-HP, Hopital Pitié-Salpétrière, Service d'Urologie, Paris, France; UPMC Univ. Paris 06, GRC5, ONCOTYPE-Uro, Institut Universitaire de Cancérologie, Paris, France. 6. Division of Urologic Surgery and Center for Surgery and Public Health, Brigham and Women's Hospital/Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA. 7. Department of Urology, Medical University of Vienna, Vienna, Austria. 8. Department of Surgical, Oncological and Gastroenterologic Sciences, Urology Clinic, University of Padua, Italy. 9. Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USA. 10. Department of Urology, Hospital Universitario Puerta de Hierro-Majadahonda, Universidad Autónoma de Madrid, Madrid, Spain. 11. Department of Urology, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan. 12. Department of Urology, Landesklinikum Korneuburg, Korneuburg, Austria. 13. Department of Urology, University of Montreal, Montreal, QC, Canada. 14. Department of Urology, Vita-Salute University, Milan, Italy. 15. Department of Urology, University Hospital Basel, Basel, Switzerland. 16. Department of Urology, Weill Cornell Medical College, New York-Presbyterian Hospital, New York, NY, USA; Department of Urology, Medical University of Vienna, Vienna, Austria; Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USA. Electronic address: sfshariat@gmail.com.
Abstract
BACKGROUND: To test the hypothesis that perioperative blood transfusion (PBT)impacts oncologic outcomes of patients treated with radical nephroureterectomy (RNU) for upper tract urothelial carcinoma (UTUC). METHODS: Retrospective analysis of 2492 patients with UTUC treated at 23 institutions with RNU between 1987 and 2007.Cox regression models addressed the association of PBT with disease recurrence, cancer-specific mortality and any-cause mortality. RESULTS: A total of 510 patients (20.5%) patients received PBT. Within a median follow-up of 36 months (Interquartile range: 55 months), 663 (26.6%) patients experienced disease recurrence, 545 patients (21.9%) died of UTUC and 884 (35.5%) patients died from any cause. Patients who received PBT were at significantly higher risk of disease recurrence, cancer-specific mortality and overall mortality than patients not receiving PBT in univariable Cox regression analyses. 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). CONCLUSIONS: In patients undergoing RNU for UTUC, PBT is associated with disease recurrence, cancer-specific survival or overall survival in univariable, but not in multivariable Cox regression analyses.
BACKGROUND: To test the hypothesis that perioperative blood transfusion (PBT)impacts oncologic outcomes of patients treated with radical nephroureterectomy (RNU) for upper tract urothelial carcinoma (UTUC). METHODS: Retrospective analysis of 2492 patients with UTUC treated at 23 institutions with RNU between 1987 and 2007.Cox regression models addressed the association of PBT with disease recurrence, cancer-specific mortality and any-cause mortality. RESULTS: A total of 510 patients (20.5%) patients received PBT. Within a median follow-up of 36 months (Interquartile range: 55 months), 663 (26.6%) patients experienced disease recurrence, 545 patients (21.9%) died of UTUC and 884 (35.5%) patients died from any cause. Patients who received PBT were at significantly higher risk of disease recurrence, cancer-specific mortality and overall mortality than patients not receiving PBT in univariable Cox regression analyses. 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). CONCLUSIONS: In patients undergoing RNU for UTUC, PBT is associated with disease recurrence, cancer-specific survival or overall survival in univariable, but not in multivariable Cox regression analyses.
Authors: Aditya Bagrodia; Samuel Kaffenberger; Andrew Winer; Katie Murray; Michael Vacchio; Junting Zheng; Irina Ostrovnaya; Bernard H Bochner; Guido Dalbagni; Eugene K Cha; Jonathan A Coleman Journal: World J Urol Date: 2018-01-17 Impact factor: 4.226