Negative impact of blood transfusion on recurrence and prognosis of hepatocellular carcinoma after hepatic resection.
BACKGROUND
In perioperative management of hepatic resection for hepatocellular carcinoma, excessive blood loss and blood transfusion greatly influence postoperative complications and prognosis of the patients. We evaluated the influence of blood products use on postoperative recurrence and prognosis of patients with hepatocellular carcinoma.


METHODS
The subjects were 66 patients who underwent elective hepatic resection for hepatocellular carcinoma without concomitant microwave or radiofrequency ablation therapy nor other malignancies between January 2001 and June 2006. We retrospectively investigated the influence of the use of blood products including red cell concentration and fresh frozen plasma on recurrence of hepatocellular carcinoma and overall survival.


RESULTS
In multivariate analysis, the dose of blood products transfusion was a significant predictor of disease-free and overall survival. Both disease-free and overall survival rates of those who were given blood products were significantly worse than those who did not receive. On the other hand, in univariate analysis of disease-free and overall survival after hepatic resection and clinical variables, the amount of blood loss was not a significant predictor of recurrence or death.


CONCLUSIONS
Transfusion of blood products is associated with increased recurrence rate and worse survival after elective hepatic resection for patients with hepatocellular carcinoma.
Shiba
Hiroaki
H
Department of Surgery, Jikei University School of Medicine, Tokyo, Japan. hs0817@jikei.ac.jp
Ishida
Yuichi
Y
Wakiyama
Shigeki
S
Iida
Tomonori
T
Matsumoto
Michinori
M
Sakamoto
Taro
T
Ito
Ryusuke
R
Gocho
Takeshi
T
Furukawa
Kenei
K
Fujiwara
Yuki
Y
Hirohara
Shoichi
S
Misawa
Takeyuki
T
Yanaga
Katsuhiko
K
D000368:Aged; D000704:Analysis of Variance; D001803:Blood Transfusion / Q000379:methods; D006528:Carcinoma, Hepatocellular / Q000401:mortality* / Q000473:pathology / Q000628:therapy*; D017115:Catheter Ablation / Q000379:methods; D016009:Chi-Square Distribution; D015331:Cohort Studies; D018572:Disease-Free Survival; D005260:Female; D006498:Hepatectomy / Q000379:methods; D006801:Humans; D015994:Incidence; D008113:Liver Neoplasms / Q000401:mortality* / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology*; D009367:Neoplasm Staging; D019990:Perioperative Care / Q000379:methods; D011336:Probability; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D018570:Risk Assessment; D016019:Survival Analysis; D065227:Transfusion Reaction