Blood transfusion is associated with increased perioperative morbidity and adverse oncologic outcomes in bladder cancer patients receiving neoadjuvant chemotherapy and radical cystectomy

Gil Ben-Horin
Published: Aug 16, 2016

A single-center, retrospective analysis performed at Johns Hopkins examined the effect of leukoreduced perioperative blood transfusion (PBT) on oncologic outcomes and perioperative morbidity in radical cystectomy (RC) patients who received neoadjuvant chemotherapy (NAC), quantifying exposure with a novel dose index variable. This is the first study to examine the effect of PBT on morbidity and cancer-specific survival (CSS) in patients who uniformly received NAC prior to undergoing RC for bladder cancer. The authors queried the Johns Hopkins Radical Cystectomy database for patients who had undergone NAC followed by RC from 2010 to 2013. Using this database, along with the MetaVision electronic anaesthesia records, the authors were able to differentiate intraoperative and postoperative transfusions. The study results showed that PBT was associated with increased perioperative morbidity and length of stay and that intraoperative BT was independently associated with adverse oncologic outcomes after adjusting for clinical and pathologic parameters. The authors propose that a restrictive transfusion strategy may reduce morbidity and decrease length of stay after RC.

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Blood transfusion is associated with increased perioperative morbidity and adverse oncologic outcomes in bladder cancer patients receiving neoadjuvant chemotherapy and radical cystectomy

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