Abstract
BackgroundA number of studies have investigated the effect of perioperative blood transfusion (PBT) for patients after radical prostatectomy (RP), with some reporting conflicting results. A systematic review of the literature and a meta-analysis were conducted to explore the association between PBT (autologous or allogeneic) and biochemical recurrence-free survival (BRFS), overall survival (OS) and cancer-specific survival (CSS) in patients undergoing RP.MethodsThe PubMed, Medline, Cochrane Library, and Embase databases were searched for published controlled clinical studies on perioperative allogeneic or autologous blood transfusion (BT) and patient survival after RP. STATA software version 12.0 was used for data analysis. We used hazard ratios (HRs) and 95% confidence intervals (CIs) to test the correlation between BT and patient survival after RP.ResultsData from a total of 26,698 patients in ten published studies were included in the meta-analysis. The meta-analysis results showed that autologous BT was not associated with BRFS (HR: 1.06; 95% CI: 0.96–1.18; Z = 1.17; P = 0.24), OS (HR: 0.86; 95% CI: 0.71–1.04; Z = 1.58; P = 0.11), or CSS (HR: 0.98; 95% CI: 0.49–1.96; Z = 0.05; P = 0.96). Allogeneic BT exhibited a significant association with worse BRFS (HR: 1.09; 95% CI: 1.01–1.16; Z = 2.37; P = 0.02), OS (HR: 1.43; 95% CI: 1.24–1.64; Z = 4.95; P<0.01) and CSS (HR: 1.74; 95% CI: 1.18–2.56; Z = 2.81; P = 0.005).ConclusionOur data showed an association between allogeneic BT and reduced BRFS, OS and CSS in patients after RP. These findings indicate that perioperative blood conservation strategies are important for decreasing the allogeneic BT rate.
Highlights
Prostate cancer (PCa) is a common malignant tumor of the male urogenital system, the second leading cause of cancer mortality in men worldwide and a significant cause of death in elderly men [1,2]
The meta-analysis results showed that autologous Blood transfusion (BT) was not associated with biochemical recurrence-free survival (BRFS) (HR: 1.06; 95% confidence intervals (CIs): 0.96–1.18; Z = 1.17; P = 0.24), overall survival (OS) (HR: 0.86; 95% CI: 0.71–1.04; Z = 1.58; P = 0.11), or cancer-specific survival (CSS) (HR: 0.98; 95% CI: 0.49–1.96; Z = 0.05; P = 0.96)
Allogeneic BT exhibited a significant association with worse BRFS (HR: 1.09; 95% CI: 1.01–1.16; Z = 2.37; P = 0.02), OS (HR: 1.43; 95% CI: 1.24–1.64; Z = 4.95; P
Summary
Prostate cancer (PCa) is a common malignant tumor of the male urogenital system, the second leading cause of cancer mortality in men worldwide and a significant cause of death in elderly men [1,2]. A relationship between autologous or allogeneic transfusion and the recurrence of PCa has been reported [9,10]. To obtain most conclusive results, we conducted a systematic review of the literature to explore the association between perioperative BT (PBT; autologous or allogeneic) and biochemical recurrence-free survival (BRFS), overall survival (OS) and cancer-specific survival (CSS) in patients undergoing RP. A number of studies have investigated the effect of perioperative blood transfusion (PBT) for patients after radical prostatectomy (RP), with some reporting conflicting results. A systematic review of the literature and a meta-analysis were conducted to explore the association between PBT (autologous or allogeneic) and biochemical recurrence-free survival (BRFS), overall survival (OS) and cancer-specific survival (CSS) in patients undergoing RP.
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