title: [Effects of perioperative transfusion of blood components on the long-term prognosis of hepatocellular carcinoma].
abstract: Objective:To investigate the effects of perioperative transfusion of blood components on the long-term prognosis of hepatocellular carcinoma (HCC) patients.Methods:A total of 339 patients with primary HCC who underwent curative hepatectomy between January 2003 and December 2010 at the Cancer Hospital, Chinese Academy of Medical Sciences were enrolled. The clinical data of the patients were retrospectively analyzed. These patients were divided into non-transfusion, fresh frozen plasma (FFP) transfusion only and concentrated red cells (CRC) transfusion groups. Disease-free survival and overall survival were estimated using the Kaplan-Meier method, and Cox regression was performed to identify clinicopathological factors related with survival.Results:Among the 339 patients, the 1-, 3- and 5-year disease-free survival rates were 63.1%, 35.4% and 22.4%, respectively, and the median disease-free survival was 22 months. While the 1-, 3- and 5-year overall survival rates were 90.5%, 69.5% and 56.4%, respectively, and the median overall survival was 72 months. The median disease-free survivals of the non-transfusion (n=181), FFP transfusion only (n=48) and CRC transfusion (n=110) groups were 28, 22 and 12 months, respectively, while the median overall survivals of the three groups were 99, 63 and 40 months respectively. Significant differences in the disease-free and overall survivals were observed among the three groups (bothP<0.01). Multivariate Cox regression analyses showed that FFP transfusion only (HR=1.658,P=0.026), CRC transfusion (HR=1.470,P=0.030), serum alpha-fetoprotein>400 μg/L (HR=1.686,P=0.002), albumin<35 g/L (HR=1.782,P=0.047), tumor capsule (HR=0.597,P=0.012), tumor necrosis (HR=1.820,P=0.001) and the TNM stage Ⅲ or above (HR=2.537,P=0.000) were independent predictors of overall survival after hepatectomy.Conclusion:Both perioperative FFP only transfusion and CRC transfusion may have detrimental effect on the long-term prognosis of HCC.
authors.affiliation: Department of Blood Transfusion, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.
authors.forename: T
authors.initials: T
authors.lastname: Peng
authors.forename: L M
authors.initials: LM
authors.lastname: Wang
authors.forename: J X
authors.initials: JX
authors.lastname: Wu
authors.forename: M
authors.initials: M
authors.lastname: Liu
authors.forename: X Y
authors.initials: XY
authors.lastname: Li
authors.forename: W Q
authors.initials: WQ
authors.lastname: Rong
authors.forename: F
authors.initials: F
authors.lastname: Wu
authors.forename: W Q
authors.initials: WQ
authors.lastname: Zhao
authors.forename: G H
authors.initials: GH
authors.lastname: Zhao
mesh_terms: D001803:Blood Transfusion; D006528:Carcinoma, Hepatocellular / Q000601:surgery*; D018572:Disease-Free Survival; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000601:surgery*; D019990:Perioperative Care; D011379:Prognosis; D012189:Retrospective Studies
keywords: Blood transfusion; Liver neoplasms; Prognosis