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World Journal of Surgery
Published in: World Journal of Surgery 4/2015

01-04-2015 | Original Scientific Report

Blood Transfusion is Associated with Recurrence of Hepatocellular Carcinoma After Hepatectomy in Child–Pugh Class A Patients

Authors: Noboru Harada, Ken Shirabe, Takashi Maeda, Hiroto Kayashima, Teruyoshi Ishida, Yoshihiko Maehara

Published in: World Journal of Surgery | Issue 4/2015

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Abstract

Introduction

Previous reports have indicated an association between blood transfusion and prognosis of hepatocellular carcinoma (HCC) after hepatectomy. However, clinicopathological biases were not adjusted in these studies. We aimed to clarify the effect of blood transfusions in patients with HCC and Child–Pugh class A after hepatectomy by using inverse probability of treatment weighting (IPTW) analysis for selection bias control.

Materials and methods

We enrolled 479 patients with primary HCC and Child–Pugh class A retrospectively (91 transfused and 388 nontransfused patients) who underwent curative hepatectomy. After adjusting for different covariate distributions for both groups by IPTW, we analyzed the prognostic outcomes.

Results

In the unweighted analyses, overall survival (OS) rate of transfused patients was significantly lower than in nontransfused patients (P < 0.0001). Recurrence-free survival (RFS) rate of transfused patients was significantly lower than that of nontransfused patients (P = 0.0024). Multivariate analysis showed that blood transfusion was an independent prognostic factor of OS and RFS. The different distributive covariates between the two groups were age, presence of liver cirrhosis, serum level of alpha-fetoprotein, maximum tumor diameter, and amount of intraoperative blood loss. After IPTW by these covariates, OS rate of transfused patients was not significantly lower than those of nontransfused patients, whereas RFS rate of transfused patients remained significantly lower than those of nontransfused patients (P = 0.038, adjusted HR 1.45; 95 % CI 1.0–2.1).

Conclusions

These results suggest that blood transfusion was associated with recurrence of HCC after hepatectomy in patients with HCC and Child–Pugh class A.
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Metadata
Title
Blood Transfusion is Associated with Recurrence of Hepatocellular Carcinoma After Hepatectomy in Child–Pugh Class A Patients
Authors
Noboru Harada
Ken Shirabe
Takashi Maeda
Hiroto Kayashima
Teruyoshi Ishida
Yoshihiko Maehara
Publication date
01-04-2015
Publisher
Springer US
Published in
World Journal of Surgery / Issue 4/2015
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-014-2891-6

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