The association between transfusion and cancer-free survival after curative resection for hepatocellular carcinoma.
BACKGROUND
In cases of surgery for hepatocellular carcinoma (HCC), postoperative intrahepatic recurrence is the main obstacle to long-term survival of patients. The association between perioperative transfusion and recurrence-free survival was studied in 126 patients with HCC who underwent hepatic resection between 1985 and 1990 and in whom complete follow-up information was available until 1992.


METHODS
Patients who received neither whole blood nor packed erythrocytes during hospitalization formed the no transfusion group (n = 72), and the remaining patients who were given either whole blood or packed erythrocytes during hospitalization constituted the transfusion group (n = 54).


RESULTS
The 1-year, 3-year, and 5-year recurrence-free survival rates of the nontransfused versus transfused groups were 80.6% versus 74.1%, 50.9% versus 33.4%, and 37.1% versus 26.2%, respectively (P = 0.1590). After adjustment for other covariates, the serum albumin level and histological intrahepatic metastasis (im) remained as significant variables for recurrence-free survival. Although there was no association between the erythrocyte transfusion and the recurrence-free survival of the patients with serum albumin levels either more than 3.5 g/dl or less than or equal to 3.5 g/dl, the 1-year, 3-year, and 5-year recurrence-free survival rates of the nontransfused versus transfused groups of the patients with im-negative HCC were 92.2% versus 80.0%, 62.6% versus 36.3%, and 47.4% versus 27.1%, respectively (P = 0.0254).


CONCLUSIONS
The association between erythrocyte transfusion and the recurrence-free survival was recognized only in patients with im-negative HCC.
Matsumata
T
T
Second Department of Surgery, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
Ikeda
Y
Y
Hayashi
H
H
Kamakura
T
T
Taketomi
A
A
Sugimachi
K
K
D000328:Adult; D000368:Aged; D001803:Blood Transfusion; D006528:Carcinoma, Hepatocellular / Q000601:surgery* / Q000628:therapy; D005260:Female; D006801:Humans; D007432:Intraoperative Period; D008113:Liver Neoplasms / Q000601:surgery* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D012044:Regression Analysis; D013997:Time Factors