Negative Impact of Intra-Operative Blood Transfusion on Survival Outcomes of Hepatocellular Carcinoma Patients

Abstract

Background

Studies have reported that blood transfusion may have an association with survival outcomes of cancer patients. This study was aimed at finding the effect of intra-operative blood transfusion on the prognosis of patients of hepatocellular carcinoma (HCC).

Methods

This was a retrospective study. HCC patients who underwent tumor resection from January 2013 to November 2018 at Harbin Medical University Cancer Hospital were included. The survival time of patients receiving or not receiving blood transfusion during the operation were compared.

Results

Of HCC patients, 21.1% (102/484) received intra-operative blood transfusion. After propensity score matching, 87 pairs of patients were included in the study. In the subset of patients with a tumor size of >4 cm, univariable analysis found that there were significant differences in recurrence-free survival (RFS; P=0.004) and overall survival (OS; P=0.028) between blood transfusion and non-blood transfusion groups. After multivariable Cox regression analysis, intra-operative blood transfusion was an independent risk factor for RFS (HR: 2.011, 95% CI: 1.146–3.529, P=0.015), but not for OS (HR: 1.862, 95% CI: 0.933–3.715, P=0.078) in the subset of patients with a tumor size of >4 cm.

Conclusion

Intra-operative blood transfusion was associated with worse RFS in HCC patients with a tumor size of >4 cm.

Keywords:

• hepatocellular carcinoma
• intra-operative blood transfusion
• recurrence-free survival
• overall survival

Disclosure

The authors report no conflicts of interest in this work.

Additional information

Funding

This work was supported by the Haiyan Foundation of Harbin Medical University Cancer Hospital (JJZD2023-12).