You have accessJournal of UrologyBladder Cancer: Invasive1 Apr 20111597 IMPACT OF NEOADJUVANT CHEMOTHERAPY ON ANEMIA AND PERIOPERATIVE OUTCOMES AT THE TIME OF CYSTECTOMY Timothy Atkinson, Randall Rowland, John Rinehart, Daniel Davenport, Stephen Strup, and Paul Crispen Timothy AtkinsonTimothy Atkinson Lexington, KY More articles by this author , Randall RowlandRandall Rowland Lexington, KY More articles by this author , John RinehartJohn Rinehart Lexington, KY More articles by this author , Daniel DavenportDaniel Davenport Lexington, KY More articles by this author , Stephen StrupStephen Strup Lexington, KY More articles by this author , and Paul CrispenPaul Crispen Lexington, KY More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.1647AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES While neoadjuvant chemotherapy (NC) prior to cystectomy has demonstrated a survival advantage in patients with T2-4aN0MO urothelial carcinoma, the impact of NC on anemia and perioperative outcomes is not well defined. Here we evaluate the impact of NC on preoperative anemia, need for blood transfusions in the perioperative period and postoperative complications at the time of cystectomy. METHODS A single institution retrospective review from 2005 to 2009 for patients undergoing radical cystectomy for T2-4aN0M0 urothelial carcinoma was performed. Patients receiving NC were matched 2:1 with patients not receiving NC (controls) for age, gender, and BMI. Comparisons of patient co-morbidity (Charlson score), hemoglobin (Hgb), need for transfusions, estimated blood loss, postoperative complications, and severity of complications (Clavien grade) were made. Statistical comparisons were performed with Kruskal-Wallis Test and Chi-square Tests as appropriate. RESULTS 20 patients receiving NC were matched with 40 patients not receiving NC (controls). Patients receiving NC and controls did not differ significantly in age, BMI, Charlson co-morbidity score, operative time or estimated blood loss during surgery. Baseline Hgb (prior to NC) was similar between groups. Preoperative Hgb (following NC) was significantly lower in NC patients (11.7 + 1.7 g/dL) compared to controls (13.6 + 1.5 g/dL), p = 0.0014. Patients receiving NC (70%) were more likely to receive a blood transfusion during surgery compared to controls (38%), p = 0.17. Additionally, the number of units of blood transfused was significantly greater in NC patients (3.2 units) compared to controls (1.4 units), p = 0.004. Postoperative transfusion requirements, days until oral intake, length of hospital stay, postoperative complication rates and severity of postoperative complications were similar between groups. CONCLUSIONS NC was not associated with an increased rate of postoperative complications. However, NC was associated with a lower preoperative Hgb and an increased need for blood transfusion during cystectomy. Despite increased blood transfusion requirements associated with NC, we continue to advocate the use of NC in appropriate candidates given the survival advantage noted in randomized trials. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e641 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Timothy Atkinson Lexington, KY More articles by this author Randall Rowland Lexington, KY More articles by this author John Rinehart Lexington, KY More articles by this author Daniel Davenport Lexington, KY More articles by this author Stephen Strup Lexington, KY More articles by this author Paul Crispen Lexington, KY More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...