Iranian Journal of Pathology

Prognostic Implication and Survival Outcomes of Perioperative Blood Transfusion on Urological Malignancies Undergoing Radical Surgical Intervention

Document Type : Original Research

Authors

Sujata Mallick 1
Mahasweta Mallik 2
Puskar Shyam Chowdhury 3

1 Department of Pathology, KPC Medical College, West Bengal University of Health Science, Kolkata, India

2 Department of Pathology, NSMCH, Bihta, Aryabhatta University, Patna, India

3 Department of Urology, KPC Medical College, Professor, West Bengal University of Health Science, Kolkata, India

https://doi.org/10.30699/ijp.2023.553040.2887
Abstract
Background & Objective: Background and objective: Perioperative blood transfusion (PBT) during radical urological surgeries has been associated with an increased incidence of complications. The present study analyzes the outcome of perioperative blood transfusion (PBT) and the prognostic implications after radical surgeries on patients with malignant urological tumors.
Methods: Our retrospective study included 792 cases of partial or radical nephrectomy /cystectomy/prostatectomy surgeries for kidney/bladder/ prostate carcinoma from 2012 to 2022. Data on preoperative, intraoperative, and pathological parameters were evaluated. PBT was taken as a period of transfusion of allogenic RBC during/preoperative/postoperative surgeries. The effect of PBT on oncological parameters like recurrence-free survival (RFS), overall survival (OS), and cancer-free survival (CSS) was compared using univariate cox regression analysis (Odds ratio, Hazard ratio).
Results: PBT was applied on 124 (20.6%) patients of nephrectomy, 54 (46.5%) patients of cystectomy, and 23 (31%) patients of prostatectomy. The baseline characteristics of the cohort study found symptomatic patients with older age and other co-morbidities to be transfusion-dependent. Also, the patients undergoing radical operations with more blood loss and advanced tumor stage were more likely to receive PBT. PBT was significantly associated with survival outcomes (P<0.05) in nephrectomy and cystectomy cases but independent of association in prostatectomy cases.
Conclusion: The result of this study concludes that in nephrectomy and cystectomy operations, PBT had a significant association with cancer recurrence and mortality; however, in prostatectomy cases, no significant correlation was noted. Thus, proper criteria to prevent the unnecessary use of PBT and more defined parameters for transfusion are needed to improve postoperative survival. Autologous transfusion should be considered more frequently. However, more extensive studies and randomized trials are needed in this area.

Keywords

Perioperative blood transfusion
Urological malignancies
Nephrectomy
cystectomy
Prostatectomy

Subjects

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Iranian Journal of Pathology
Volume 18, Issue 1
Winter 2023
Pages 33-48

  • Receive Date 01 May 2022
  • Revise Date 21 July 2022
  • Accept Date 25 September 2022

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