The impact of perioperative blood transfusion on survival and recurrence after radical prostatectomy for prostate cancer: A systematic review and meta-analysis

Pushan, Zhang; Manbiao, Chen; Liu, Sulai; Li, Jun; Zhang, Rui‐Dong; Ye, Han-shen

doi:10.4103/0973-1482.193115

Cited by 14 publications

(6 citation statements)

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“…Our findings showed that the ERAS/FTS could shorten LOS, time to first anus exhaust, and reduce the incidence of complications, while not aggravating the patient's postoperative pain. It is worth mentioning that the ERAS/FTS program also did not increase the risk of blood transfusion and readmission; the former has been associated with adverse survival and recurrence outcomes (25), while the latter may increase medical costs and indicate more serious post-discharge adverse events (26).…”

Section: Discussionmentioning

confidence: 98%

Impact of enhanced recovery after surgery or fast track surgery pathways in minimally invasive radical prostatectomy: a systematic review and meta-analysis

Lv¹,

Cai²,

Jiang³

et al. 2020

Transl Androl Urol

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Background: The enhanced recovery after surgery (ERAS) and fast track surgery (FTS) protocols have been applied to a variety of surgeries and have been proven to reduce complications, accelerate rehabilitation, and reduce medical costs. However, the effectiveness of these protocols in minimally invasive radical prostatectomy (miRP) is still unclear. Thus, this study aimed to evaluate the impact of ERAS and FTS protocols in miRP.Methods: We searched PubMed, Cochrane Library, Embase, and Web of Science databases to collect randomized and observational studies comparing ERAS/FTS versus conventional care in miRP up to July 1, 2019. After screening for inclusion, data extraction, and quality assessment by two independent reviewers, the meta-analysis was performed with the RevMan 5.3 and STATA 15.1 software. Results were expressed as risk ratio (RR) and weighted mean difference (WMD) with 95% confidence intervals (CIs).Results: In total, 11 studies involving 1,207 patients were included. Pooled data showed that ERAS/FTS was associated with a significant reduction in length of stay (LOS) (WMD: -2.41 days, 95% CI: -4.00 to -0.82 days, P=0.003), time to first anus exhaust (WMD: -0.74 days, 95% CI: -1.14 to -0.34 days, P=0.0003), and lower incidence of postoperative complications (RR: 0.70, 95% CI: 0.53 to 0.92, P=0.01). No significant differences were found between groups for operation time, estimated blood loss, postoperative pain, blood transfusion rate, and readmission rate (P>0.01).Conclusions: Our meta-analysis suggests that the ERAS/FTS protocol is safe and effective in miRP.However, more extensive, long-term, prospective, multicenter follow-up studies, and randomized controlled trials (RCTs) are required to validate our findings.

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Section: Discussionmentioning

confidence: 98%

Impact of enhanced recovery after surgery or fast track surgery pathways in minimally invasive radical prostatectomy: a systematic review and meta-analysis

Lv¹,

Cai²,

Jiang³

et al. 2020

Transl Androl Urol

View full text Add to dashboard Cite

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“…There has been some disagreement with regard to whether transfusion may influence on BCR after radical prostatectomy. As mentioned in the introduction, a recent meta-analysis including 8 studies showed that perioperative blood transfusion was associated with decreased overall survival and recurrence-free survival rate following open radical prostatectomy [ 11 ]. In contrast to these findings, Boehm et al analyzed 11,723 patients who were treated with open radical prostatectomy or RARLP and found no correlation between blood transfusion and oncological outcomes [ 23 ].…”

Section: Discussionmentioning

confidence: 99%

“…Previous work has identified preoperative prostate specific antigen (PSA), pathologic T stage, surgical margin, as independent predictors of 5-year BCR following open prostatectomy [ 6 ]. Moreover, a recent meta-analysis showed that blood transfusion increased the 5-year BCR in patients undergoing open prostatectomy [ 11 ]. However, it has not yet been established whether blood transfusion can increase the 5-year BCR in patients undergoing RARP.…”

Section: Introductionmentioning

confidence: 99%

Blood transfusion had no influence on the 5-year biochemical recurrence after robot-assisted radical prostatectomy: a retrospective study

et al. 2021

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Background Although red blood cells (RBC) transfusion is known to be significantly associated with biochemical recurrence in patients undergoing open prostatectomy, its influence on biochemical recurrence after robot-assisted laparoscopic radical prostatectomy remains unclear. Therefore, this study aimed to validate the effect of RBC transfusion on the 5-year biochemical recurrence in patients undergoing robot-assisted laparoscopic radical prostatectomy. Methods This study retrospectively analyzed the medical records of patients who underwent robot-assisted laparoscopic radical prostatectomy at single tertiary academic hospital between October 2007 and December 2014. Univariate and multivariate Cox proportional hazard regression analysis was performed to identify any potential variables associated with 5-year biochemical recurrence. Results A total of 1311 patients were included in the final analysis. Of these, 30 patients (2.3%) were transfused with RBC either during robot-assisted laparoscopic radical prostatectomy or during their hospital stay, which corresponded to 5-year biochemical recurrence of 15.7%. Multivariate Cox proportional hazard regression analysis showed that RBC transfusion had no influence on the 5-year biochemical recurrence. Variables including pathologic T stage (Hazard ratio [HR] 3.5, 95% confidence interval [CI] 2.4–5.1 p < 0.001), N stage (HR 2.3, 95% CI 1.5–3.7, p < 0.001), Gleason score (HR 2.4, 95% CI 1.8–3.2, p < 0.001), and surgical margin (HR 2.0, 95% CI 1.5–2.8, p < 0.001) were independently associated with the 5-year biochemical recurrence. Conclusions RBC transfusion had no significant influence on the 5-year biochemical recurrence in patients undergoing robot-assisted laparoscopic radical prostatectomy.

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“…It is well known that perioperative blood transfusion is associated with shortened long-term survival after cancer (including pancreatic cancer) surgery. 39,40 As a matter of fact, high volume intraoperative blood loss is also associated with worse outcomes including increased postoperative complications 41 and deteriorated long-term outcomes. 42,43 For example, in a retrospective study of patients with stage II/III gastric cancer, intraoperative blood loss of >330 mL was associated with early recurrence after surgery.…”

Section: Perioperative Glucocorticoids and Recurrence-free Survivalmentioning

confidence: 99%

Perioperative Glucocorticoids are Associated with Improved Recurrence-Free Survival After Pancreatic Cancer Surgery: A Retrospective Cohort Study with Propensity Score-Matching

Zhang¹,

Mu²,

Jin

et al. 2021

TCRM

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Purpose: Perioperative anesthetic management may affect long-term outcome after cancer surgery. This study investigated the effect of perioperative glucocorticoids on long-term survival in patients after radical resection for pancreatic cancer. Methods: In this retrospective cohort study with propensity score-matching, patients who underwent radical resection for pancreatic cancer from January 2005 to December 2016 were recruited. Baseline and perioperative data including use of glucocorticoids for prevention of postoperative nausea and vomiting were collected. Patients were followed up by qualified personnel for cancer recurrence and survival. The primary outcome was the recurrence-free survival. Outcomes were compared before and after propensity matching. The association between perioperative glucocorticoid use and recurrence-free survival was analyzed with multivariable regression models. Results: A total of 215 patients were included in the study; of these, 112 received perioperative glucocorticoids and 103 did not. Patients were followed up for a median of 74.0 months (95% confidence interval [CI] 68.3-79.7). After propensity score-matching, 64 patients remained in each group. The recurrence-free survivals were significantly longer in patients with glucocorticoids than in those without (full cohort: median 12.0 months [95% CI 6.0-28.0] vs 6.

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The impact of perioperative blood transfusion on survival and recurrence after radical prostatectomy for prostate cancer: A systematic review and meta-analysis

Abstract: The findings from the current meta-analysis demonstrate that PBT was associated with adverse survival and recurrence outcomes for prostate cancer patients undergoing RP.

Cited by 14 publications

References 0 publications

Impact of enhanced recovery after surgery or fast track surgery pathways in minimally invasive radical prostatectomy: a systematic review and meta-analysis

Impact of enhanced recovery after surgery or fast track surgery pathways in minimally invasive radical prostatectomy: a systematic review and meta-analysis

Blood transfusion had no influence on the 5-year biochemical recurrence after robot-assisted radical prostatectomy: a retrospective study

Perioperative Glucocorticoids are Associated with Improved Recurrence-Free Survival After Pancreatic Cancer Surgery: A Retrospective Cohort Study with Propensity Score-Matching

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