Do perioperative blood transfusions impact oncological outcomes of robot-assisted radical cystectomy with intracorporeal urinary diversion? Results from a large multi-institutional registry

被引:4
作者
Sarkis, Julien [1 ,20 ]
Diamand, Romain [2 ]
Aoun, Fouad [3 ]
Assenmacher, Gregoire [4 ]
Assenmacher, Christophe [4 ]
Verhoest, Gregory [5 ]
Holz, Serge [6 ]
Naudin, Michel [6 ]
Ploussard, Guillaume [7 ,8 ]
Mari, Andrea [9 ]
Minervini, Andrea [9 ]
Tay, Andrea [10 ]
Issa, Rami [10 ]
Roumiguie, Mathieu [11 ]
Bajeot, Anne S. [11 ]
Simone, Giuseppe [12 ]
Anceschi, Umberto [12 ]
Umari, Paolo [13 ]
Sridhar, Ashwin [13 ]
Kelly, John [13 ]
Hendricksen, Kees [14 ]
Einerhand, Sarah [14 ]
Mertens, Laura S. [14 ]
Sanchez-Salas, Rafael [15 ]
Colomer, Anna [15 ]
Quackels, Thierry [1 ]
Peltier, Alexandre [2 ]
Montorsi, Francesco [16 ]
Briganti, Alberto [16 ]
Pradere, Benjamin [17 ,18 ]
Moschini, Marco [16 ]
Roumeguere, Thierry [1 ,2 ]
Albisinni, Simone [1 ,19 ]
EAU YAU
机构
[1] Univ Libre Bruxelles, Univ Clin Brussels, Erasme Hosp, Dept Urol, Brussels, Belgium
[2] Univ Libre Bruxelles, Jules Bordet Inst, Dept Urol, Brussels, Belgium
[3] Hotel Dieu France, Dept Urol, Beirut, Lebanon
[4] Clin Europe St Elisabeth, Dept Urol, Brussels, Belgium
[5] CHU Rennes, Dept Urol, Rennes, France
[6] CHU Ambroise Pare, Dept Urol, Mons, Belgium
[7] La Croix Sud Hosp, Dept Urol, Quint Fonsegrives, France
[8] Inst Univ Canc Toulouse Oncopole, Toulouse, France
[9] Univ Florence, Careggi Univ Hosp, Dept Expt & Clin Med, Unit Oncol Minimally Invas Urol & Androl, Florence, Italy
[10] St George Hosp, Dept Urol, London, England
[11] Paul Sabatier Univ, CHU Rangueil, Dept Urol Androl & Renal Transplantat, Toulouse, France
[12] IRCCS Regina Elena Natl Canc Inst, Dept Urol, Rome, Italy
[13] UCL, Div Surg & Intervent Sci, London, England
[14] Netherlands Canc Inst, Dept Urol, Amsterdam, Netherlands
[15] Montsouris Mutualiste Inst, Dept Urol, Paris, France
[16] Univ Vita Salute San Raffaele, IRCCS San Raffaele Hosp, Urol Res Inst, Div Oncol,Unit Urol, Milan, Italy
[17] Med Univ Vienna, Comprehens Canc Ctr, Dept Urol, Vienna, Austria
[18] Croix Sud Hosp, Dept Urol UROSUD, Quint Fonsegrives, France
[19] Univ Roma Tor Vergata, Tor Vergata Univ Hosp, Dept Surg Sci, Unit Urol, Rome, Italy
[20] Free Univ Brussels, Univ Clin Brussels, Erasme Hosp, Dept Urol, Route Lennik 808, Brussels, Belgium
来源
MINERVA UROLOGY AND NEPHROLOGY | 2023年 / 75卷 / 01期
关键词
Urinary bladder neoplasms; Cystectomy; Blood transfusion; Robotic surgical procedures; INVASIVE BLADDER-CANCER; NEOADJUVANT CHEMOTHERAPY; UROTHELIAL CARCINOMA; SURVIVAL; SURGERY;
D O I
10.23736/S2724-6051.22.05109-6
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
BACKGROUND: Blood transfusions (BT) have been associated with adverse oncologic outcomes in multiple malignan-cies including open radical cystectomy (ORC) for urothelial carcinoma of the bladder (UCB). Robot-assisted radical cys-tectomy (RARC) with intracorporeal urinary diversion (ICUD) delivers similar oncologic outcomes compared to ORC, yet with lower blood loss and reduced transfusions. However, the impact of BT after robotic cystectomy is still unknown.METHODS: This is a multicenter study including patients treated for UCB with RARC and ICUD in 15 academic institu-tions, between January 2015 and January 2022. BT were administered during surgery (intraoperative blood transfusions, iBT) or during the first 30 days after surgery (post-operative blood transfusions, pBT). The association of iBT and pBT with recurrence-free survival (RFS), cancer-specific survival (CSS) and overall survival (OS) were evaluated by univari-ate and multivariate regression analysis. RESULTS: A total of 635 patients were included in the study. Overall, 35/635 patients (5.51%) received iBT while 70/635 (11.0%) received pBT. After a mean follow-up of 23 +/- 18 months, 116 patients (18.3%) had died, including 96 (15.1%) from bladder cancer. Recurrence occurred in 146 patients (23%). iBT were associated with decreased RFS, CSS and OS (P<0.001) on univariate Cox analysis. After adjusting for clinicopathologic covariates, iBT were associated only with the risk of recurrence (HR: 1.7; 95% CI, 1.0-2.8, P=0.04). pBT were not significantly associated to RFS, CSS or OS on univariate and multivariate Cox regression models (P>0.05).CONCLUSIONS: In the present study, patients treated by RARC with ICUD for UCB have a higher risk of recurrence after iBT, yet no significant association with CSS and OS was found. pBT are not associated with worse oncological prognosis.
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页码:50 / 58
页数:9
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