MP83-17 IMPACT OF INTRA-OPERATIVE TRANSFUSION ON SURVIVAL OF PATIENTS WITH CLINICALLY LOCALIZED PROSTATE CANCER UNDERGOING RADICAL PROSTATECTOMY

Abstract

You have accessJournal of UrologyProstate Cancer: Localized IX1 Apr 2015MP83-17 IMPACT OF INTRA-OPERATIVE TRANSFUSION ON SURVIVAL OF PATIENTS WITH CLINICALLY LOCALIZED PROSTATE CANCER UNDERGOING RADICAL PROSTATECTOMY Marco Moschini, R. Jeffrey Karnes, Nazareno Suardi, Giorgio Gandaglia, Marco Bianchi, Nicola Fossati, Ettore Di Trapani, Andrea Gallina, Umberto Capitanio, Andrea Salonia, Francesco Montorsi, and Alberto Briganti Marco MoschiniMarco Moschini More articles by this author , R. Jeffrey KarnesR. Jeffrey Karnes More articles by this author , Nazareno SuardiNazareno Suardi More articles by this author , Giorgio GandagliaGiorgio Gandaglia More articles by this author , Marco BianchiMarco Bianchi More articles by this author , Nicola FossatiNicola Fossati More articles by this author , Ettore Di TrapaniEttore Di Trapani More articles by this author , Andrea GallinaAndrea Gallina More articles by this author , Umberto CapitanioUmberto Capitanio More articles by this author , Andrea SaloniaAndrea Salonia More articles by this author , Francesco MontorsiFrancesco Montorsi More articles by this author , and Alberto BrigantiAlberto Briganti More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.1892AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Few studies investigated the impact of peri-operative blood transfusions (PBT) on survival in the context of prostate cancer (PCa). Additionally, none of them has taken into account the role of its timing. Intra-operative transfusion has indeed been recently associated to detrimental effect on survival in other uro-oncological settings such as bladder cancer. The aim of the study was to evaluate the impact of intra and postoperative transfusion on survival in patients treated with radical prostatectomy (RP) for clinically localized PCa METHODS The study included 28,247 patients treated with RP for PCa at a two major referral centers between January 1985 and August 2013. Univariable (UVA) and multivariable (MVA) Cox regression analyses tested the relationship between PBT and cancer specific mortality (CSM) and overall mortality (OM). PBT was defined as receipt of packed red blood cells either during surgery (intraoperative blood transfusion) or during the postsurgical hospitalization (postoperative blood transfusion). Multivariable analyses (MVA) were adjusted for age, pathological Gleason score (GS), pathological stage, lymph node invasion (LNI) positive surgical margin (PSM) and institution of origin. Finally, in those patients receiving PBT, the effect of the number of blood units received on CSM was tested RESULTS Overall, 5,718 (20.0%) patients received PBT (mean number of blood unit received: 2). Of these, 3,568 (62.4%) patients received intra-operative transfusion and 3,003 (37.6%) received postoperative transfusion. Mean follow up time was 123 months (median 142). At MVA, PBT was significantly associated with CSM (Hazard ratio (HR): 1.25; p=0.006) but not with OM (p=0.4). However, when analyses were repeated according to the timing of administration, only intra-operative transfusion was associated with increased CSM rates (HR:1.45; p<0.001) and OM (HR: 1.08; p=0.04). Conversely, postoperative transfusion was not significantly related to CSM and OM (p>0.4). Considering only patients who received PBT, at MVA the number of blood units received was associated with higher CSM rates (HR: 1.01, p=0.05). However, no effect was recorded considering OM as endpoint CONCLUSIONS Intra-operative transfusion during RP showed adverse impact on disease specific survival of patients with PCa, as shown in other urological malignancies. Although clear mechanisms explaining this association remain to be established, PBT are known to negatively affect the immune system through suppression of cellular immunity. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e1056 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Marco Moschini More articles by this author R. Jeffrey Karnes More articles by this author Nazareno Suardi More articles by this author Giorgio Gandaglia More articles by this author Marco Bianchi More articles by this author Nicola Fossati More articles by this author Ettore Di Trapani More articles by this author Andrea Gallina More articles by this author Umberto Capitanio More articles by this author Andrea Salonia More articles by this author Francesco Montorsi More articles by this author Alberto Briganti More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...