title: No impact of perioperative blood transfusion on recurrence of hepatocellular carcinoma after hepatectomy.
abstract: BACKGROUND
  Although several studies have shown that perioperative blood transfusion is a poor prognostic factor of outcome after hepatectomy for hepatocellular carcinoma (HCC), the impact of perioperative blood transfusion on the prognosis of HCC remains unknown.
  
  
  METHODS
  Data from 835 patients (76 transfused patients and 759 nontransfused patients) who underwent curative hepatectomy for HCC were retrospectively collected and analyzed. To overcome bias due to the different distribution of covariates for the two groups, a one-to-one match was created using propensity score analysis. After matching, patient outcomes were analyzed.
  
  
  RESULTS
  After one-to-one matching, 60 transfused patients and 60 nontransfused patients had the same preoperative and operative characteristics (excluding operative blood loss). Although the morbidity rate of hepatectomy was significantly higher in the transfused group than in the nontransfused group (P = 0.016), there was no significant difference in mortality rate (P = 0.242). Additionally, the overall survival rate of transfused patients was similar to that of nontransfused patients (P = 0.466), and the difference in disease-free survival rate between the two groups was insignificant (P = 0.621).
  
  
  CONCLUSIONS
  Perioperative blood transfusion did not influence the overall and disease-free survival rate in the HCC patients studied. Perioperative blood transfusion may not be considered a poor prognostic factor for patients with HCC.
authors.affiliation: Department of Gastroenterological Surgery, Hiroshima University Hospital, 1-2-3, Kasumi, Hiroshima 734-8551, Japan.
authors.forename: Shintaro
authors.initials: S
authors.lastname: Kuroda
authors.forename: Hirotaka
authors.initials: H
authors.lastname: Tashiro
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Kobayashi
authors.forename: Akihiko
authors.initials: A
authors.lastname: Oshita
authors.forename: Hironobu
authors.initials: H
authors.lastname: Amano
authors.forename: Hideki
authors.initials: H
authors.lastname: Ohdan
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001803:Blood Transfusion; D006528:Carcinoma, Hepatocellular / Q000453:epidemiology* / Q000401:mortality; D018572:Disease-Free Survival; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000453:epidemiology* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology*; D059035:Perioperative Period; D011379:Prognosis; D057216:Propensity Score; D016019:Survival Analysis; D055815:Young Adult