Department of Liver Surgery, Liver Cancer Institute, Zhongshan Hospital, Fudan University, 180 FengLin Road, Shanghai, 200032, China.
Key Laboratory of Carcinogenesis and Cancer Invasion of Ministry of Education, Shanghai, China.
BMC Cancer. 2017 Nov 14;17(1):762. doi: 10.1186/s12885-017-3745-z.
Whether perioperative blood transfusions (PBTs) adversely influence oncological outcomes for intrahepatic cholangiocarcinoma (ICC) patients after curative resection remains undetermined.
Of the 605 patients who underwent curative liver resection for ICC between 2000 and 2012, 93 received PBT. We conducted Cox regression and variable selection logistic regression analyses to identify confounding factors of PBT. Propensity score matching (PSM) and Cox regression analyses were used to compare the overall survival (OS) and disease-free survival (DFS) between the patients with or without PBT.
After exclusion, 93 eligible patients (15.4%) received PBT, compared with 512 (84.6%) who did not receive PBT; the groups were highly biased in terms of the propensity score (PS) analysis (0.096 ± 0.104 vs. 0.479 ± 0.372, p < 0.001). PBT was associated with an increased risk of OS (HR: 1.889, 95% CI: 1.446-2.468, p < 0.001) and DFS (HR: 1.589, 95% CI: 1.221-2.067, p < 0.001) in the entire cohort. After propensity score matching (PSM), no bias was observed between the groups (PS,0.136 ± 0.117 VS. 0.193 ± 0.167, p = 0.785). In the multivariate Cox analysis, PBT was not associated with increased risks of OS (HR: 1.172, 95% CI: 0.756-1.816, p = 0.479) and DFS (HR: 0.944, 95% CI: 0.608-1.466, p = 0.799). After propensity score adjustment, PBT was still not associated with OS or DFS after ICC curative resection.
The present study found that PBT did not affect DFS and OS after curative resection of ICC.
在接受根治性切除术后，围手术期输血（PBT）是否会对肝内胆管癌（ICC）患者的肿瘤学结局产生不利影响仍不确定。
在 2000 年至 2012 年间接受根治性肝切除术治疗 ICC 的 605 名患者中，有 93 名患者接受了 PBT。我们进行了 Cox 回归和变量选择逻辑回归分析，以确定 PBT 的混杂因素。采用倾向评分匹配（PSM）和 Cox 回归分析比较了有和无 PBT 的患者的总生存期（OS）和无病生存期（DFS）。
排除后，93 名符合条件的患者（15.4%）接受了 PBT，而 512 名（84.6%）患者未接受 PBT；两组在倾向评分（PS）分析方面存在严重偏差（0.096±0.104 与 0.479±0.372，p<0.001）。在整个队列中，PBT 与 OS（HR：1.889，95%CI：1.446-2.468，p<0.001）和 DFS（HR：1.589，95%CI：1.221-2.067，p<0.001）的风险增加相关。在进行倾向评分匹配（PSM）后，两组之间没有观察到偏差（PS，0.136±0.117 VS. 0.193±0.167，p=0.785）。在多变量 Cox 分析中，PBT 与 OS（HR：1.172，95%CI：0.756-1.816，p=0.479）和 DFS（HR：0.944，95%CI：0.608-1.466，p=0.799）的风险增加无关。在进行倾向评分调整后，PBT 与 ICC 根治性切除术后的 OS 或 DFS 仍无关。
本研究发现，PBT 不会影响 ICC 根治性切除术后的 DFS 和 OS。
