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Allogeneic Blood Transfusion Does Not Affect Outcome After Curative Resection for Advanced Cholangiocarcinoma

Müller, Sascha ; Mehrabi, Arianeb ; Rahbari, Nuh ; Warschkow, Rene ; Elbers, Heike ; Leowardi, Christine ; Fonouni, Hamidreza ; Tarantino, Ignazio ; Schemmer, Peter ; Schmied, Bruno ; Büchler, Markus

In: Annals of Surgical Oncology, 2014, vol. 21, no. 1, p. 155-164

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    Title
    • Allogeneic Blood Transfusion Does Not Affect Outcome After Curative Resection for Advanced Cholangiocarcinoma
    Author
    • Müller, Sascha. Department of General, Visceral and Transplant Surgery, University Hospital Heidelberg, Heidelberg, Germany
    • Mehrabi, Arianeb. Department of General, Visceral and Transplant Surgery, University Hospital Heidelberg, Heidelberg, Germany
    • Rahbari, Nuh. Department of General, Visceral and Transplant Surgery, University Hospital Heidelberg, Heidelberg, Germany
    • Warschkow, Rene. Department of Surgery, Kantonsspital St. Gallen, St. Gallen, Switzerland
    • Elbers, Heike. Department of General, Visceral and Transplant Surgery, University Hospital Heidelberg, Heidelberg, Germany
    • Leowardi, Christine. Department of General, Visceral and Transplant Surgery, University Hospital Heidelberg, Heidelberg, Germany
    • Fonouni, Hamidreza. Department of General, Visceral and Transplant Surgery, University Hospital Heidelberg, Heidelberg, Germany
    • Tarantino, Ignazio. Department of General, Visceral and Transplant Surgery, University Hospital Heidelberg, Heidelberg, Germany
    • Schemmer, Peter. Department of General, Visceral and Transplant Surgery, University Hospital Heidelberg, Heidelberg, Germany
    • Schmied, Bruno. Department of General, Visceral and Transplant Surgery, University Hospital Heidelberg, Heidelberg, Germany
    • Büchler, Markus. Department of General, Visceral and Transplant Surgery, University Hospital Heidelberg, Heidelberg, Germany
    Document Type
    • Postprint
    Language
    • English
    Published in
    • Annals of Surgical Oncology, 2014, vol. 21, no. 1, p. 155-164. Springer US; http://www.springer-ny.com
    Other Version
    Classification
    • Health
    OAI-PMH Identifier
    • oai:doc.rero.ch:324896
    Summary
    Purpose: To assess the impact of perioperative blood transfusion on overall and disease-free survival in patients undergoing curative resection for cholangiocarcinoma. Methods: In a single-center study, 128 patients undergoing curative resection for cholangiocarcinoma between 2001 and 2010 were assessed. The median follow-up period was 19months. Transfused and nontransfused patients were compared by Cox regression and propensity score analyses. Results: Overall, 38 patients (29.7%) received blood transfusions. The patient characteristics were highly biased with respect to receiving transfusions (propensity score 0.69±0.22 vs. 0.11±0.16, p<0.001). In the unadjusted analysis, blood transfusion was associated with a 105% increased risk of mortality [hazard ratio (HR) 2.05, 95% CI 1.19-3.51, p=0.010]. In the multivariate (HR 1.14, 95% CI 0.52-2.48, p=0.745) and the propensity score-adjusted Cox regression (HR 1.02, 95% CI 0.39-2.62, p=0.974), blood transfusion had no influence on overall survival. Similarly, in the propensity score-adjusted Cox regression (HR 0.62, 95% CI 0.24-1.58, p=0.295), no relevant effect of blood transfusion on disease-free survival was observed. Conclusions: To our knowledge, this is the first propensity score-based analysis providing compelling evidence that the worse oncological outcome after curative resection for advanced cholangiocarcinoma in patients receiving perioperative blood transfusions is caused by the clinical circumstances requiring the transfusions, not by the blood transfusions themselves.