Dekker Annemiek M, Wiggers Jimme K, Coelen Robert J, van Golen Rowan F, Besselink Marc G H, Busch Olivier R C, Verheij Joanne, Hollmann Markus W, van Gulik Thomas M
Department of Surgery, Academic Medical Centre (AMC), Amsterdam, The Netherlands.
Department of Pathology, Amsterdam Medical Center, Amsterdam, The Netherlands.
HPB (Oxford). 2016 Mar;18(3):262-70. doi: 10.1016/j.hpb.2015.08.004. Epub 2016 Jan 6.
Perioperative blood transfusions have been associated with worse oncological outcome in several types of cancer. The objective of this study was to assess the effect of perioperative blood transfusions on time to recurrence and overall survival (OS) in patients who underwent curative-intent resection of perihilar cholangiocarcinoma (PHC).
This retrospective cohort study included consecutive patients with resected PHC between 1992 and 2013 in a specialized center. Patients with 90-day mortality after surgery were excluded. Patients who did and did not receive perioperative blood transfusions were compared using univariable Kaplan-Meier analysis and multivariable Cox regression.
Of 145 included patients, 80 (55.2%) received perioperative blood transfusions. The median OS was 49 months for patients without and 41 months for patients with blood transfusions (P = 0.46). In risk-adjusted multivariable Cox regression analysis, blood transfusion was not associated with OS (HR 1.00, 95% CI 0.59-1.68, P = 0.99) or time to recurrence (HR 1.00, 95% CI 0.57-1.78, P = 0.99). In addition, no differences in effect were found between different types of blood products transfused.
Blood transfusion was not associated with survival or time to recurrence after curative resection of PHC in this series. The alleged association is presumably related to the circumstances necessitating blood transfusions.
围手术期输血与几种癌症的肿瘤学预后较差有关。本研究的目的是评估围手术期输血对接受肝门部胆管癌（PHC）根治性切除患者的复发时间和总生存期（OS）的影响。
这项回顾性队列研究纳入了1992年至2013年在一个专科中心接受PHC切除的连续患者。排除术后90天内死亡的患者。使用单变量Kaplan-Meier分析和多变量Cox回归比较接受和未接受围手术期输血的患者。
在纳入的145例患者中，80例（55.2%）接受了围手术期输血。未输血患者的中位OS为49个月，输血患者为41个月（P = 0.46）。在风险调整的多变量Cox回归分析中，输血与OS（风险比1.00，95%可信区间0.59 - 1.68，P = 0.99）或复发时间（风险比1.00，95%可信区间0.57 - 1.78，P = 0.99）无关。此外,不同类型的输血制品在效果上没有差异。
在本系列研究中，PHC根治性切除术后输血与生存或复发时间无关。所谓的关联可能与需要输血的情况有关。
