Effect of Prolonged Storage of Packed Red Blood Cells on Recurrence-free and Overall Survivals after Curative Resection for Hepatocellular Carcinoma
10.13471/j.cnki.j.sun.yat-sen.univ（med.sci）.2022.0313
- VernacularTitle:输注陈旧红细胞对肝细胞癌切除术后病人预后的影响
- Author:
Rui-feng XUE
1
;
Chong-xi ZHAO
2
;
Pei-zong WANG
1
;
Dong-tai CHEN
1
;
Xiao-hui CHEN
3
;
Wei-an ZENG
1
;
Qiang LI
1
Author Information
1. Department of Anesthesiology， Sun Yat-sen University Cancer Center， Guangzhou 510060，China
2. Department of Anesthesiology， Zhongshan Ophthalmic Center， Sun Yat-sen University， Guangzhou 510060，China
3. Department of Anesthesiology， Fujian Provincial Hospital， Fuzhou 350001，China
- Publication Type:Journal Article
- Keywords:
hepatocellular carcinoma;
intraoperative blood transfusion;
fresh packed red blood cells;
old packed red blood cells;
long-time prognosis
- From:
Journal of Sun Yat-sen University(Medical Sciences)
2022;43(3):449-461
- CountryChina
- Language:Chinese
-
Abstract:
ObjectiveProlonged storage of packed red blood cells （PRBC） is reportedly associated with poor clinical outcomes in critically ill， trauma， and cardiac surgery patients. However， the impact of PRBC’s age on long-term oncological outcomes in cancer patients remains poorly defined. Here we retrospectively evaluated the effect of PRBC’s age on overall survival and biochemical recurrence in patients undergoing curative resection of hepatocellular carcinoma. MethodsA total of 1 221 qualified patients undergoing curative hepatectomy for HCC between August 1， 2008 and June 30， 2012 at the Sun Yat-sen University Cancer Center （Guangzhou， PR China） were divided into nontransfused or transfused group. Transfused patients were further divided according to PRBC storage duration （fresh PRBC group， ≤ 14 days； old PRBC group， > 14 days）. Overall survival （OS）， intrahepatic recurrence-free survival （IRFS）， extrahepatic metastasis-free survival （EMFS） were assessed and multivariate analyses were performed to evaluate the association of PRBC storage duration with cancer outcomes. ResultsA total of 251 （20.6%） patients received intraoperative PRBC transfusion. Of these， 112 and 125 patients were grouped in the fresh and the old PRBC groups， respectively. The Kaplan–Meier curves showed that both fresh PRBC group and old PRBC group had worse OS， IRFS， and EMFS than nontransfused group （P<0.001）. Cox regression analyses further indicated that old PRBC transfusion was an independent prognostic factor of OS （HR=1.417， P=0.049）， IRFS （HR=1.519， P=0.013） for patients with HCC； conversely， new PRBC transfusion was not. ConclusionIn patients undergoing curative hepatectomy， intraoperative transfusions of PRBC that had been stored for more than 2 weeks is independently associated with a significantly increased risk of intrahepatic recurrence and reduced overall survival.
