Perioperative blood transfusion and survival following curative hepatic resection for hepatocellular carcinoma.
OBJECTIVE
The association between transfusion and recurrence after resection for hepatocellular carcinoma (HCC) is still under debate. The influences of perioperative blood transfusion on survival and recurrence after curative hepatic resection for HCC and prognostic factors in patients with blood transfusion were evaluated.


METHODS
Curative hepatectomy was performed in 210 patients (57%) with and 158 (43%) without perioperative blood transfusion. Prognostic factors were evaluated by univariate and multivariate analysis using Cox's proportional hazards model.


RESULTS
Multivariate analysis revealed that perioperative blood transfusion was an independent predictor for recurrence in patients with serum low albumin level (< 3.5 g/dL). In transfused group, stage IV, large tumor size (> or = 5 cm), high value of ICGR15 (> or = 20%), and old age (> or = 60 year) were independent factors of poor disease-free survival.


CONCLUSIONS
Perioperative blood transfusion promotes the recurrence of HCC after hepatic resection in patients with hypo-albuminemia. In transfused patients, establishment of strategy for recurrence based on pTNM staging, tumor size, ICGR15, and age may be required to improve survival.
Hanazaki
Kazuhiro
K
Department of Surgery, Shinshu University School of Medicine, Matsumoto, Japan. hanayan@hsp.md.shinshu-u.ac.jp
Kajikawa
Shoji
S
Shimozawa
Nobuhiko
N
Matsushita
Akimasa
A
Machida
Taiichi
T
Shimada
Ko
K
Yazawa
Kazuyuki
K
Koide
Naohiko
N
Adachi
Wataru
W
Amano
Jun
J
D000368:Aged; D000375:Aging; D001803:Blood Transfusion; D006528:Carcinoma, Hepatocellular / Q000378:metabolism / Q000473:pathology / Q000601:surgery*; D004396:Coloring Agents / Q000493:pharmacokinetics; D005260:Female; D006498:Hepatectomy; D006801:Humans; D007208:Indocyanine Green / Q000493:pharmacokinetics; D007430:Intraoperative Care; D008113:Liver Neoplasms / Q000378:metabolism / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D011182:Postoperative Care; D011300:Preoperative Care; D011379:Prognosis; D012189:Retrospective Studies; D012709:Serum Albumin / Q000172:deficiency; D016019:Survival Analysis; D013997:Time Factors
D004396:Coloring Agents; D012709:Serum Albumin; D007208:Indocyanine Green