Systematic Review and Meta-Analysis on the Role of Perioperative Blood Transfusion in Patients Undergoing Radical Cystectomy for Urothelial Carcinoma

Kochergin, Maxim; Fahmy, Omar; Esken, Lisa; Goetze, Thorsten; Xylinas, Evanguelos; Stief, Christian G. und Gakis, Georgios (2022): Systematic Review and Meta-Analysis on the Role of Perioperative Blood Transfusion in Patients Undergoing Radical Cystectomy for Urothelial Carcinoma. In: Bladder Cancer, Bd. 8, Nr. 3: S. 315-327

Abstract

BACKGROUND: Radical cystectomy (RC) is the standard of care in patients with muscle-invasive bladder cancer. The impact of perioperative red blood cell (RBC) transfusion on oncological outcomes after RC is not clearly established as the existing publications show conflicting results. OBJECTIVES: The aim of this systematic review and meta-analysis was to investigate the prognostic role of perioperative RBC transfusion on oncological outcomes after RC. METHODS: Systematic online search on PubMed was conducted, based on PRISMA criteria for publications reporting on RBC transfusion during RC. Publications with the following criteria were included: (I) reported data on perioperative blood transfusion;(II) Reported Hazard ratio (HR) and 95%-confidence interval (CI) for the impact of transfusion on survival outcomes. Primary outcome was the impact of perioperative RBC transfusion on recurrence-free survival (RFS), cancerspecific survival (CSS) and overall survival (OS). Risk of bias assessment was performed using Newcastle-Ottawa Scale. Statistical analysis was performed using Revman 5.4 software. RESULTS: From 27 primarily identified publications, 19 eligible articles including 22897 patients were selected. Perioperative RBC transfusion showed no impact on RFS (Z = 1.34;p = 0,18) and significant negative impact on CSS (Z = 2.67;p = 0.008) and OS (Z = 3.22;p = 0.001). Intraoperative RBC transfusion showed no impact on RFS (Z = 0.58;p = 0.56) and CSS (Z = 1.06;p = 0.29) and OS (Z = 1.47;p = 0.14). Postoperative RBC transfusion showed non-significant trend towards improved RFS (Z = 1.89;p = 0.06) and no impact on CSS (Z = 1.56;p = 0.12) and OS (Z = 0.53 p = 0.60). CONCLUSION: In this meta-analysis, we found perioperative blood transfusion to be a significant predictor only for worse CSS and OS but not for RFS. This effect may be determined by differences in tumor stages and patient comorbidities for which this meta-analysis cannot control due to lack of respective raw data.

• Dokumententyp: Zeitschriftenartikel
• Fakultät: Medizin
• Themengebiete: 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit
• ISSN: 2352-3727
• Sprache: Englisch