MP64-09 DECREASE IN LONG-TERM DISEASE-SPECIFIC SURVIVAL WITH PERIOPERATIVE BLOOD TRANSFUSION FOLLOWING RADICAL CYSTECTOMY

Abstract

You have accessJournal of UrologyBladder Cancer: Natural History and Pathophysiology1 Apr 2015MP64-09 DECREASE IN LONG-TERM DISEASE-SPECIFIC SURVIVAL WITH PERIOPERATIVE BLOOD TRANSFUSION FOLLOWING RADICAL CYSTECTOMY Bethany K. Burge, Robert H. Blackwell, Evan Carlos, Robert C. Flanigan, Gopal N. Gupta, and Marcus L. Quek Bethany K. BurgeBethany K. Burge More articles by this author , Robert H. BlackwellRobert H. Blackwell More articles by this author , Evan CarlosEvan Carlos More articles by this author , Robert C. FlaniganRobert C. Flanigan More articles by this author , Gopal N. GuptaGopal N. Gupta More articles by this author , and Marcus L. QuekMarcus L. Quek More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.2320AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Radical cystectomy (RC) is a morbid procedure, which can be associated with substantial blood loss and need for perioperative blood transfusion (PBT). PBT has been associated with a decrease in disease-specific survival for patients undergoing surgery for other malignancies. We hypothesize that receipt of PBT may have an immunosuppressive effect that can impact the natural course of bladder cancer after definitive surgical treatment. We evaluate the effects of blood transfusion on overall (OS), disease-specific (DSS), and recurrence-free survival(RFS)in patients who underwent RC for bladder carcinoma. METHODS A retrospective review was performed of 521 patients who underwent RC at Loyola University Medical Center from 1996 to 2014. Patients were categorized into two cohorts; those who did and did not receive PBT. Student's T-test was used to assess continuous variables, and Pearson's Chi-squared test to assess categorical variables. The effect of PBT on OS, DSS, and RFS were estimated using the Kaplan-Meier method and compared with the log-rank test. RESULTS Blood transfusion data was available for 487 patients (93.5%), with an overall mean follow up of 30 months. Of these patients, 243 (49.8%) received PBT. Cohorts were well-matched with regards to cancer-specific variables, with no differences between pathologic tumor stage, nodal stage, presence of lymphovascular invasion, primary histology, or presence of positive margins. PBT patients were older than control patients (mean age 69.1 vs 66.7, p<0.05). DSS and OS were found to be significantly decreased in PBT patients compared to controls, at median 77.8 months vs. 111.1 months (p=0.002) and 54.5 months vs. 80.3 months (p=0.002), respectively. Figures A and B. RFS approaches significance favoring improved freedom from recurrence in control patients, at median 64.4 months vs. 100.4 months respectively (p=0.059). CONCLUSIONS RC patients who received PBT had a decreased OS and DSS. Coupled with a trend toward a higher rate of cancer recurrence in the PBT group, these results suggest that receipt of blood products may have an immunosuppressive effect that impairs the body's ability to fight microscopic residual disease, contributing to poorer survival in this cohort. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e801 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Bethany K. Burge More articles by this author Robert H. Blackwell More articles by this author Evan Carlos More articles by this author Robert C. Flanigan More articles by this author Gopal N. Gupta More articles by this author Marcus L. Quek More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...