Peri‐operative allogeneic blood transfusion does not adversely affect oncological outcomes after radical cystectomy for urinary bladder cancer: a propensity score‐weighted European multicentre study
Objectives To evaluate the effect of peri‐operative blood transfusion (PBT) on recurrence‐free survival, overall survival, cancer‐specific mortality and other‐cause mortality in patients undergoing radical cystectomy (RC), using a contemporary European multicentre cohort. Patients and Methods The Pr...
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| Veröffentlicht in: | BJU international 2018-01, Vol.121 (1), p.101-110 |
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| creator | Vetterlein, Malte W. Gild, Philipp Kluth, Luis A. Seisen, Thomas Gierth, Michael Fritsche, Hans‐Martin Burger, Maximilian Protzel, Chris Hakenberg, Oliver W. Landenberg, Nicolas Roghmann, Florian Noldus, Joachim Nuhn, Philipp Pycha, Armin Rink, Michael Chun, Felix K.‐H. May, Matthias Fisch, Margit Aziz, Atiqullah Bartsch, G Bolenz, C Brookman‐May, S Buchner, A Durschnabel, M Ellinger, J Froehner, M Georgieva, G Gilfrich, C Gördük, M Grimm, MO Hadaschik, B Haferkamp, A Hartmann, F Herrmann, E Hertle, L Hohenfellner, M Janetschek, G Keck, B Kraischits, N Krausse, A Lusuardi, L Martini, T Michel, MS Moritz, R Müller, SC Novotny, V Pahernik, S Palisaar, RJ Ponholzer, A Roigas, J Schmid, M Schramek, P Seitz, C Sikic, D Stief, CG Syring, I Traumann, M Vallo, S Wagenlehner, FM Weidner, W Wirth, MP Wullich, B |
| description | Objectives
To evaluate the effect of peri‐operative blood transfusion (PBT) on recurrence‐free survival, overall survival, cancer‐specific mortality and other‐cause mortality in patients undergoing radical cystectomy (RC), using a contemporary European multicentre cohort.
Patients and Methods
The Prospective Multicentre Radical Cystectomy Series (PROMETRICS) includes data on 679 patients who underwent RC at 18 European tertiary care centres in 2011. The association between PBT and oncological survival outcomes was assessed using Kaplan–Meier, Cox regression and competing‐risks analyses. Imbalances in clinicopathological features between patients receiving PBT vs those not receiving PBT were mitigated using conventional multivariable adjusting as well as inverse probability of treatment weighting (IPTW).
Results
Overall, 611 patients had complete information on PBT, and 315 (51.6%) received PBT. The two groups (PBT vs no PBT) differed significantly with respect to most clinicopathological features, including peri‐operative blood loss: median (interquartile range [IQR]) 1000 (600–1500) mL vs 500 (400–800) mL (P < 0.001). Independent predictors of receipt of PBT in multivariable logistic regression analysis were female gender (odds ratio [OR] 5.05, 95% confidence interval [CI] 2.62–9.71; P < 0.001), body mass index (OR 0.91, 95% CI 0.87–0.95; P < 0.001), type of urinary diversion (OR 0.38, 95% CI 0.18–0.82; P = 0.013), blood loss (OR 1.32, 95% CI 1.23–1.40; P < 0.001), neoadjuvant chemotherapy (OR 2.62, 95% CI 1.37–5.00; P = 0.004), and ≥pT3 tumours (OR 1.59, 95% CI 1.02–2.48; P = 0.041). In 531 patients with complete data on survival outcomes, unweighted and unadjusted survival analyses showed worse overall survival, cancer‐specific mortality and other‐cause mortality rates for patients receiving PBT(P < 0.001, P = 0.017 and P = 0.001, respectively). After IPTW adjustment, those differences no longer held true. PBT was not associated with recurrence‐free survival (hazard ratio [HR] 0.92, 95% CI 0.53–1.58; P = 0.8), overall survival (HR 1.06, 95% CI 0.55–2.05; P = 0.9), cancer‐specific mortality (sub‐HR 1.09, 95% CI 0.62–1.92; P = 0.8) and other‐cause mortality (sub‐HR 1.00, 95% CI 0.26–3.85; P > 0.9) in IPTW‐adjusted Cox regression and competing‐risks analyses. The same held true in conventional multivariable Cox and competing‐risks analyses, where PBT could not be confirmed as a predictor of any given endpoint (all P values >0.05).
Conclusion
The present re |
| doi_str_mv | 10.1111/bju.14012 |
| format | Article |
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To evaluate the effect of peri‐operative blood transfusion (PBT) on recurrence‐free survival, overall survival, cancer‐specific mortality and other‐cause mortality in patients undergoing radical cystectomy (RC), using a contemporary European multicentre cohort.
Patients and Methods
The Prospective Multicentre Radical Cystectomy Series (PROMETRICS) includes data on 679 patients who underwent RC at 18 European tertiary care centres in 2011. The association between PBT and oncological survival outcomes was assessed using Kaplan–Meier, Cox regression and competing‐risks analyses. Imbalances in clinicopathological features between patients receiving PBT vs those not receiving PBT were mitigated using conventional multivariable adjusting as well as inverse probability of treatment weighting (IPTW).
Results
Overall, 611 patients had complete information on PBT, and 315 (51.6%) received PBT. The two groups (PBT vs no PBT) differed significantly with respect to most clinicopathological features, including peri‐operative blood loss: median (interquartile range [IQR]) 1000 (600–1500) mL vs 500 (400–800) mL (P < 0.001). Independent predictors of receipt of PBT in multivariable logistic regression analysis were female gender (odds ratio [OR] 5.05, 95% confidence interval [CI] 2.62–9.71; P < 0.001), body mass index (OR 0.91, 95% CI 0.87–0.95; P < 0.001), type of urinary diversion (OR 0.38, 95% CI 0.18–0.82; P = 0.013), blood loss (OR 1.32, 95% CI 1.23–1.40; P < 0.001), neoadjuvant chemotherapy (OR 2.62, 95% CI 1.37–5.00; P = 0.004), and ≥pT3 tumours (OR 1.59, 95% CI 1.02–2.48; P = 0.041). In 531 patients with complete data on survival outcomes, unweighted and unadjusted survival analyses showed worse overall survival, cancer‐specific mortality and other‐cause mortality rates for patients receiving PBT(P < 0.001, P = 0.017 and P = 0.001, respectively). After IPTW adjustment, those differences no longer held true. PBT was not associated with recurrence‐free survival (hazard ratio [HR] 0.92, 95% CI 0.53–1.58; P = 0.8), overall survival (HR 1.06, 95% CI 0.55–2.05; P = 0.9), cancer‐specific mortality (sub‐HR 1.09, 95% CI 0.62–1.92; P = 0.8) and other‐cause mortality (sub‐HR 1.00, 95% CI 0.26–3.85; P > 0.9) in IPTW‐adjusted Cox regression and competing‐risks analyses. The same held true in conventional multivariable Cox and competing‐risks analyses, where PBT could not be confirmed as a predictor of any given endpoint (all P values >0.05).
Conclusion
The present results did not show an adverse effect of PBT on oncological outcomes after adjusting for baseline differences in patient characteristics.</description><identifier>ISSN: 1464-4096</identifier><identifier>EISSN: 1464-410X</identifier><identifier>DOI: 10.1111/bju.14012</identifier><identifier>PMID: 28905486</identifier><language>eng</language><publisher>England: Wiley Subscription Services, Inc</publisher><subject>Analysis of Variance ; Bladder cancer ; Blood transfusion ; Blood Transfusion, Autologous - adverse effects ; Blood Transfusion, Autologous - methods ; Blood transfusions ; Body mass index ; Cancer ; Cause of Death ; Chemotherapy ; Cohort Studies ; cystectomy ; Cystectomy - methods ; Databases, Factual ; Disease-Free Survival ; Europe ; Female ; Health risk assessment ; Humans ; Kaplan-Meier Estimate ; Male ; Mortality ; Multivariate Analysis ; Perioperative Care - methods ; Prognosis ; Propensity Score ; Proportional Hazards Models ; Prospective Studies ; recurrence ; Risk Assessment ; Survival ; Survival Analysis ; Tertiary Care Centers ; Treatment Outcome ; Tumors ; Urinary bladder ; Urinary Bladder Neoplasms - mortality ; Urinary Bladder Neoplasms - pathology ; Urinary Bladder Neoplasms - surgery ; Urinary Bladder Neoplasms - therapy</subject><ispartof>BJU international, 2018-01, Vol.121 (1), p.101-110</ispartof><rights>2017 The Authors BJU International © 2017 BJU International Published by John Wiley & Sons Ltd</rights><rights>2017 The Authors BJU International © 2017 BJU International Published by John Wiley & Sons Ltd.</rights><rights>BJUI © 2018 BJU International</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3882-54bbee0dc28b58e466dba2e2d34014578a09a4ea51fbc656c03f22d7726775e83</citedby><cites>FETCH-LOGICAL-c3882-54bbee0dc28b58e466dba2e2d34014578a09a4ea51fbc656c03f22d7726775e83</cites><orcidid>0000-0002-3114-9604 ; 0000-0003-0299-489X ; 0000-0001-5987-3883</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fbju.14012$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fbju.14012$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28905486$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Vetterlein, Malte W.</creatorcontrib><creatorcontrib>Gild, Philipp</creatorcontrib><creatorcontrib>Kluth, Luis A.</creatorcontrib><creatorcontrib>Seisen, Thomas</creatorcontrib><creatorcontrib>Gierth, Michael</creatorcontrib><creatorcontrib>Fritsche, Hans‐Martin</creatorcontrib><creatorcontrib>Burger, Maximilian</creatorcontrib><creatorcontrib>Protzel, Chris</creatorcontrib><creatorcontrib>Hakenberg, Oliver W.</creatorcontrib><creatorcontrib>Landenberg, Nicolas</creatorcontrib><creatorcontrib>Roghmann, Florian</creatorcontrib><creatorcontrib>Noldus, Joachim</creatorcontrib><creatorcontrib>Nuhn, Philipp</creatorcontrib><creatorcontrib>Pycha, Armin</creatorcontrib><creatorcontrib>Rink, Michael</creatorcontrib><creatorcontrib>Chun, Felix K.‐H.</creatorcontrib><creatorcontrib>May, Matthias</creatorcontrib><creatorcontrib>Fisch, Margit</creatorcontrib><creatorcontrib>Aziz, Atiqullah</creatorcontrib><creatorcontrib>Bartsch, G</creatorcontrib><creatorcontrib>Bolenz, C</creatorcontrib><creatorcontrib>Brookman‐May, S</creatorcontrib><creatorcontrib>Buchner, A</creatorcontrib><creatorcontrib>Durschnabel, M</creatorcontrib><creatorcontrib>Ellinger, J</creatorcontrib><creatorcontrib>Froehner, M</creatorcontrib><creatorcontrib>Georgieva, G</creatorcontrib><creatorcontrib>Gilfrich, C</creatorcontrib><creatorcontrib>Gördük, M</creatorcontrib><creatorcontrib>Grimm, MO</creatorcontrib><creatorcontrib>Hadaschik, B</creatorcontrib><creatorcontrib>Haferkamp, A</creatorcontrib><creatorcontrib>Hartmann, F</creatorcontrib><creatorcontrib>Herrmann, E</creatorcontrib><creatorcontrib>Hertle, L</creatorcontrib><creatorcontrib>Hohenfellner, M</creatorcontrib><creatorcontrib>Janetschek, G</creatorcontrib><creatorcontrib>Keck, B</creatorcontrib><creatorcontrib>Kraischits, N</creatorcontrib><creatorcontrib>Krausse, A</creatorcontrib><creatorcontrib>Lusuardi, L</creatorcontrib><creatorcontrib>Martini, T</creatorcontrib><creatorcontrib>Michel, MS</creatorcontrib><creatorcontrib>Moritz, R</creatorcontrib><creatorcontrib>Müller, SC</creatorcontrib><creatorcontrib>Novotny, V</creatorcontrib><creatorcontrib>Pahernik, S</creatorcontrib><creatorcontrib>Palisaar, RJ</creatorcontrib><creatorcontrib>Ponholzer, A</creatorcontrib><creatorcontrib>Roigas, J</creatorcontrib><creatorcontrib>Schmid, M</creatorcontrib><creatorcontrib>Schramek, P</creatorcontrib><creatorcontrib>Seitz, C</creatorcontrib><creatorcontrib>Sikic, D</creatorcontrib><creatorcontrib>Stief, CG</creatorcontrib><creatorcontrib>Syring, I</creatorcontrib><creatorcontrib>Traumann, M</creatorcontrib><creatorcontrib>Vallo, S</creatorcontrib><creatorcontrib>Wagenlehner, FM</creatorcontrib><creatorcontrib>Weidner, W</creatorcontrib><creatorcontrib>Wirth, MP</creatorcontrib><creatorcontrib>Wullich, B</creatorcontrib><creatorcontrib>PROMETRICS 2011 Study Group</creatorcontrib><creatorcontrib>the PROMETRICS 2011 Study Group</creatorcontrib><title>Peri‐operative allogeneic blood transfusion does not adversely affect oncological outcomes after radical cystectomy for urinary bladder cancer: a propensity score‐weighted European multicentre study</title><title>BJU international</title><addtitle>BJU Int</addtitle><description>Objectives
To evaluate the effect of peri‐operative blood transfusion (PBT) on recurrence‐free survival, overall survival, cancer‐specific mortality and other‐cause mortality in patients undergoing radical cystectomy (RC), using a contemporary European multicentre cohort.
Patients and Methods
The Prospective Multicentre Radical Cystectomy Series (PROMETRICS) includes data on 679 patients who underwent RC at 18 European tertiary care centres in 2011. The association between PBT and oncological survival outcomes was assessed using Kaplan–Meier, Cox regression and competing‐risks analyses. Imbalances in clinicopathological features between patients receiving PBT vs those not receiving PBT were mitigated using conventional multivariable adjusting as well as inverse probability of treatment weighting (IPTW).
Results
Overall, 611 patients had complete information on PBT, and 315 (51.6%) received PBT. The two groups (PBT vs no PBT) differed significantly with respect to most clinicopathological features, including peri‐operative blood loss: median (interquartile range [IQR]) 1000 (600–1500) mL vs 500 (400–800) mL (P < 0.001). Independent predictors of receipt of PBT in multivariable logistic regression analysis were female gender (odds ratio [OR] 5.05, 95% confidence interval [CI] 2.62–9.71; P < 0.001), body mass index (OR 0.91, 95% CI 0.87–0.95; P < 0.001), type of urinary diversion (OR 0.38, 95% CI 0.18–0.82; P = 0.013), blood loss (OR 1.32, 95% CI 1.23–1.40; P < 0.001), neoadjuvant chemotherapy (OR 2.62, 95% CI 1.37–5.00; P = 0.004), and ≥pT3 tumours (OR 1.59, 95% CI 1.02–2.48; P = 0.041). In 531 patients with complete data on survival outcomes, unweighted and unadjusted survival analyses showed worse overall survival, cancer‐specific mortality and other‐cause mortality rates for patients receiving PBT(P < 0.001, P = 0.017 and P = 0.001, respectively). After IPTW adjustment, those differences no longer held true. PBT was not associated with recurrence‐free survival (hazard ratio [HR] 0.92, 95% CI 0.53–1.58; P = 0.8), overall survival (HR 1.06, 95% CI 0.55–2.05; P = 0.9), cancer‐specific mortality (sub‐HR 1.09, 95% CI 0.62–1.92; P = 0.8) and other‐cause mortality (sub‐HR 1.00, 95% CI 0.26–3.85; P > 0.9) in IPTW‐adjusted Cox regression and competing‐risks analyses. The same held true in conventional multivariable Cox and competing‐risks analyses, where PBT could not be confirmed as a predictor of any given endpoint (all P values >0.05).
Conclusion
The present results did not show an adverse effect of PBT on oncological outcomes after adjusting for baseline differences in patient characteristics.</description><subject>Analysis of Variance</subject><subject>Bladder cancer</subject><subject>Blood transfusion</subject><subject>Blood Transfusion, Autologous - adverse effects</subject><subject>Blood Transfusion, Autologous - methods</subject><subject>Blood transfusions</subject><subject>Body mass index</subject><subject>Cancer</subject><subject>Cause of Death</subject><subject>Chemotherapy</subject><subject>Cohort Studies</subject><subject>cystectomy</subject><subject>Cystectomy - methods</subject><subject>Databases, Factual</subject><subject>Disease-Free Survival</subject><subject>Europe</subject><subject>Female</subject><subject>Health risk assessment</subject><subject>Humans</subject><subject>Kaplan-Meier Estimate</subject><subject>Male</subject><subject>Mortality</subject><subject>Multivariate Analysis</subject><subject>Perioperative Care - methods</subject><subject>Prognosis</subject><subject>Propensity Score</subject><subject>Proportional Hazards Models</subject><subject>Prospective Studies</subject><subject>recurrence</subject><subject>Risk Assessment</subject><subject>Survival</subject><subject>Survival Analysis</subject><subject>Tertiary Care Centers</subject><subject>Treatment Outcome</subject><subject>Tumors</subject><subject>Urinary bladder</subject><subject>Urinary Bladder Neoplasms - mortality</subject><subject>Urinary Bladder Neoplasms - pathology</subject><subject>Urinary Bladder Neoplasms - surgery</subject><subject>Urinary Bladder Neoplasms - therapy</subject><issn>1464-4096</issn><issn>1464-410X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kc1u1TAQhSMEoqWw4AWQJTawuK2dxIkvO6jKnyrBgkrsook9Kb5y7It_WmXHI_S5-hg8CdPelgUS3tia-XzmaE5VPRf8UNA5GjflULRc1A-qfdF27aoV_PvD-zdfd3vVk5Q2nFOhk4-rvVqtuWxVt19df8Vof_-6CluMkO0FMnAunKNHq9noQjAsR_BpKskGz0zAxHzIDMwFxoRuYTBNqDMLXgf6aDU4FkrWYSYSpoyRRTC3Zb2kTGiYFzaFyEq0HuJCU8AYwjR4jfENA7aNZMcnmxeWdIhI_i7Rnv_IaNhJuWmCZ3Nx2Wr0OSJLuZjlafVoApfw2d19UJ29P_l2_HF1-uXDp-O3pyvdKFWvZDuOiNzoWo1SIW3EjFBjbRraYCt7BXwNLYIU06g72WneTHVt-r7u-l6iag6qVztdsvmzYMrDbJNG58BjKGkQa5ojRdO0hL78B92EEj25I0pJJbueC6Je7ygdQ0oRp2Eb7UyrGQQfbgIeKODhNmBiX9wplnFG85e8T5SAox1waR0u_1ca3n0-20n-AcISt4I</recordid><startdate>201801</startdate><enddate>201801</enddate><creator>Vetterlein, Malte W.</creator><creator>Gild, Philipp</creator><creator>Kluth, Luis A.</creator><creator>Seisen, Thomas</creator><creator>Gierth, 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Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-3114-9604</orcidid><orcidid>https://orcid.org/0000-0003-0299-489X</orcidid><orcidid>https://orcid.org/0000-0001-5987-3883</orcidid></search><sort><creationdate>201801</creationdate><title>Peri‐operative allogeneic blood transfusion does not adversely affect oncological outcomes after radical cystectomy for urinary bladder cancer: a propensity score‐weighted European multicentre study</title><author>Vetterlein, Malte W. ; Gild, Philipp ; Kluth, Luis A. ; Seisen, Thomas ; Gierth, Michael ; Fritsche, Hans‐Martin ; Burger, Maximilian ; Protzel, Chris ; Hakenberg, Oliver W. ; Landenberg, Nicolas ; Roghmann, Florian ; Noldus, Joachim ; Nuhn, Philipp ; Pycha, Armin ; Rink, Michael ; Chun, Felix K.‐H. ; May, Matthias ; Fisch, Margit ; Aziz, Atiqullah ; Bartsch, G ; Bolenz, C ; Brookman‐May, S ; Buchner, A ; Durschnabel, M ; Ellinger, J ; Froehner, M ; Georgieva, G ; Gilfrich, C ; Gördük, M ; Grimm, MO ; Hadaschik, B ; Haferkamp, A ; Hartmann, F ; Herrmann, E ; Hertle, L ; Hohenfellner, M ; Janetschek, G ; Keck, B ; Kraischits, N ; Krausse, A ; Lusuardi, L ; Martini, T ; Michel, MS ; Moritz, R ; Müller, SC ; Novotny, V ; Pahernik, S ; Palisaar, RJ ; Ponholzer, A ; Roigas, J ; Schmid, M ; Schramek, P ; Seitz, C ; Sikic, D ; Stief, CG ; Syring, I ; Traumann, M ; Vallo, S ; Wagenlehner, FM ; Weidner, W ; Wirth, MP ; Wullich, B</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3882-54bbee0dc28b58e466dba2e2d34014578a09a4ea51fbc656c03f22d7726775e83</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Analysis of Variance</topic><topic>Bladder cancer</topic><topic>Blood transfusion</topic><topic>Blood Transfusion, Autologous - adverse effects</topic><topic>Blood Transfusion, Autologous - methods</topic><topic>Blood transfusions</topic><topic>Body mass index</topic><topic>Cancer</topic><topic>Cause of Death</topic><topic>Chemotherapy</topic><topic>Cohort Studies</topic><topic>cystectomy</topic><topic>Cystectomy - methods</topic><topic>Databases, Factual</topic><topic>Disease-Free Survival</topic><topic>Europe</topic><topic>Female</topic><topic>Health risk assessment</topic><topic>Humans</topic><topic>Kaplan-Meier Estimate</topic><topic>Male</topic><topic>Mortality</topic><topic>Multivariate Analysis</topic><topic>Perioperative Care - methods</topic><topic>Prognosis</topic><topic>Propensity Score</topic><topic>Proportional Hazards Models</topic><topic>Prospective Studies</topic><topic>recurrence</topic><topic>Risk Assessment</topic><topic>Survival</topic><topic>Survival Analysis</topic><topic>Tertiary Care Centers</topic><topic>Treatment Outcome</topic><topic>Tumors</topic><topic>Urinary bladder</topic><topic>Urinary Bladder Neoplasms - mortality</topic><topic>Urinary Bladder Neoplasms - pathology</topic><topic>Urinary Bladder Neoplasms - surgery</topic><topic>Urinary Bladder Neoplasms - therapy</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Vetterlein, Malte W.</creatorcontrib><creatorcontrib>Gild, Philipp</creatorcontrib><creatorcontrib>Kluth, Luis A.</creatorcontrib><creatorcontrib>Seisen, Thomas</creatorcontrib><creatorcontrib>Gierth, Michael</creatorcontrib><creatorcontrib>Fritsche, Hans‐Martin</creatorcontrib><creatorcontrib>Burger, Maximilian</creatorcontrib><creatorcontrib>Protzel, Chris</creatorcontrib><creatorcontrib>Hakenberg, Oliver W.</creatorcontrib><creatorcontrib>Landenberg, Nicolas</creatorcontrib><creatorcontrib>Roghmann, Florian</creatorcontrib><creatorcontrib>Noldus, Joachim</creatorcontrib><creatorcontrib>Nuhn, Philipp</creatorcontrib><creatorcontrib>Pycha, Armin</creatorcontrib><creatorcontrib>Rink, Michael</creatorcontrib><creatorcontrib>Chun, Felix K.‐H.</creatorcontrib><creatorcontrib>May, Matthias</creatorcontrib><creatorcontrib>Fisch, Margit</creatorcontrib><creatorcontrib>Aziz, Atiqullah</creatorcontrib><creatorcontrib>Bartsch, G</creatorcontrib><creatorcontrib>Bolenz, C</creatorcontrib><creatorcontrib>Brookman‐May, S</creatorcontrib><creatorcontrib>Buchner, A</creatorcontrib><creatorcontrib>Durschnabel, M</creatorcontrib><creatorcontrib>Ellinger, J</creatorcontrib><creatorcontrib>Froehner, M</creatorcontrib><creatorcontrib>Georgieva, G</creatorcontrib><creatorcontrib>Gilfrich, C</creatorcontrib><creatorcontrib>Gördük, M</creatorcontrib><creatorcontrib>Grimm, MO</creatorcontrib><creatorcontrib>Hadaschik, B</creatorcontrib><creatorcontrib>Haferkamp, A</creatorcontrib><creatorcontrib>Hartmann, F</creatorcontrib><creatorcontrib>Herrmann, E</creatorcontrib><creatorcontrib>Hertle, L</creatorcontrib><creatorcontrib>Hohenfellner, M</creatorcontrib><creatorcontrib>Janetschek, G</creatorcontrib><creatorcontrib>Keck, B</creatorcontrib><creatorcontrib>Kraischits, N</creatorcontrib><creatorcontrib>Krausse, A</creatorcontrib><creatorcontrib>Lusuardi, L</creatorcontrib><creatorcontrib>Martini, T</creatorcontrib><creatorcontrib>Michel, MS</creatorcontrib><creatorcontrib>Moritz, R</creatorcontrib><creatorcontrib>Müller, SC</creatorcontrib><creatorcontrib>Novotny, V</creatorcontrib><creatorcontrib>Pahernik, S</creatorcontrib><creatorcontrib>Palisaar, RJ</creatorcontrib><creatorcontrib>Ponholzer, A</creatorcontrib><creatorcontrib>Roigas, J</creatorcontrib><creatorcontrib>Schmid, M</creatorcontrib><creatorcontrib>Schramek, P</creatorcontrib><creatorcontrib>Seitz, C</creatorcontrib><creatorcontrib>Sikic, D</creatorcontrib><creatorcontrib>Stief, CG</creatorcontrib><creatorcontrib>Syring, I</creatorcontrib><creatorcontrib>Traumann, M</creatorcontrib><creatorcontrib>Vallo, S</creatorcontrib><creatorcontrib>Wagenlehner, FM</creatorcontrib><creatorcontrib>Weidner, W</creatorcontrib><creatorcontrib>Wirth, MP</creatorcontrib><creatorcontrib>Wullich, B</creatorcontrib><creatorcontrib>PROMETRICS 2011 Study Group</creatorcontrib><creatorcontrib>the PROMETRICS 2011 Study Group</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>BJU international</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Vetterlein, Malte W.</au><au>Gild, Philipp</au><au>Kluth, Luis A.</au><au>Seisen, Thomas</au><au>Gierth, Michael</au><au>Fritsche, Hans‐Martin</au><au>Burger, Maximilian</au><au>Protzel, Chris</au><au>Hakenberg, Oliver W.</au><au>Landenberg, Nicolas</au><au>Roghmann, Florian</au><au>Noldus, Joachim</au><au>Nuhn, Philipp</au><au>Pycha, Armin</au><au>Rink, Michael</au><au>Chun, Felix K.‐H.</au><au>May, Matthias</au><au>Fisch, Margit</au><au>Aziz, Atiqullah</au><au>Bartsch, G</au><au>Bolenz, C</au><au>Brookman‐May, S</au><au>Buchner, A</au><au>Durschnabel, M</au><au>Ellinger, J</au><au>Froehner, M</au><au>Georgieva, G</au><au>Gilfrich, C</au><au>Gördük, M</au><au>Grimm, MO</au><au>Hadaschik, B</au><au>Haferkamp, A</au><au>Hartmann, F</au><au>Herrmann, E</au><au>Hertle, L</au><au>Hohenfellner, M</au><au>Janetschek, G</au><au>Keck, B</au><au>Kraischits, N</au><au>Krausse, A</au><au>Lusuardi, L</au><au>Martini, T</au><au>Michel, MS</au><au>Moritz, R</au><au>Müller, SC</au><au>Novotny, V</au><au>Pahernik, S</au><au>Palisaar, RJ</au><au>Ponholzer, A</au><au>Roigas, J</au><au>Schmid, M</au><au>Schramek, P</au><au>Seitz, C</au><au>Sikic, D</au><au>Stief, CG</au><au>Syring, I</au><au>Traumann, M</au><au>Vallo, S</au><au>Wagenlehner, FM</au><au>Weidner, W</au><au>Wirth, MP</au><au>Wullich, B</au><aucorp>PROMETRICS 2011 Study Group</aucorp><aucorp>the PROMETRICS 2011 Study Group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Peri‐operative allogeneic blood transfusion does not adversely affect oncological outcomes after radical cystectomy for urinary bladder cancer: a propensity score‐weighted European multicentre study</atitle><jtitle>BJU international</jtitle><addtitle>BJU Int</addtitle><date>2018-01</date><risdate>2018</risdate><volume>121</volume><issue>1</issue><spage>101</spage><epage>110</epage><pages>101-110</pages><issn>1464-4096</issn><eissn>1464-410X</eissn><abstract>Objectives
To evaluate the effect of peri‐operative blood transfusion (PBT) on recurrence‐free survival, overall survival, cancer‐specific mortality and other‐cause mortality in patients undergoing radical cystectomy (RC), using a contemporary European multicentre cohort.
Patients and Methods
The Prospective Multicentre Radical Cystectomy Series (PROMETRICS) includes data on 679 patients who underwent RC at 18 European tertiary care centres in 2011. The association between PBT and oncological survival outcomes was assessed using Kaplan–Meier, Cox regression and competing‐risks analyses. Imbalances in clinicopathological features between patients receiving PBT vs those not receiving PBT were mitigated using conventional multivariable adjusting as well as inverse probability of treatment weighting (IPTW).
Results
Overall, 611 patients had complete information on PBT, and 315 (51.6%) received PBT. The two groups (PBT vs no PBT) differed significantly with respect to most clinicopathological features, including peri‐operative blood loss: median (interquartile range [IQR]) 1000 (600–1500) mL vs 500 (400–800) mL (P < 0.001). Independent predictors of receipt of PBT in multivariable logistic regression analysis were female gender (odds ratio [OR] 5.05, 95% confidence interval [CI] 2.62–9.71; P < 0.001), body mass index (OR 0.91, 95% CI 0.87–0.95; P < 0.001), type of urinary diversion (OR 0.38, 95% CI 0.18–0.82; P = 0.013), blood loss (OR 1.32, 95% CI 1.23–1.40; P < 0.001), neoadjuvant chemotherapy (OR 2.62, 95% CI 1.37–5.00; P = 0.004), and ≥pT3 tumours (OR 1.59, 95% CI 1.02–2.48; P = 0.041). In 531 patients with complete data on survival outcomes, unweighted and unadjusted survival analyses showed worse overall survival, cancer‐specific mortality and other‐cause mortality rates for patients receiving PBT(P < 0.001, P = 0.017 and P = 0.001, respectively). After IPTW adjustment, those differences no longer held true. PBT was not associated with recurrence‐free survival (hazard ratio [HR] 0.92, 95% CI 0.53–1.58; P = 0.8), overall survival (HR 1.06, 95% CI 0.55–2.05; P = 0.9), cancer‐specific mortality (sub‐HR 1.09, 95% CI 0.62–1.92; P = 0.8) and other‐cause mortality (sub‐HR 1.00, 95% CI 0.26–3.85; P > 0.9) in IPTW‐adjusted Cox regression and competing‐risks analyses. The same held true in conventional multivariable Cox and competing‐risks analyses, where PBT could not be confirmed as a predictor of any given endpoint (all P values >0.05).
Conclusion
The present results did not show an adverse effect of PBT on oncological outcomes after adjusting for baseline differences in patient characteristics.</abstract><cop>England</cop><pub>Wiley Subscription Services, Inc</pub><pmid>28905486</pmid><doi>10.1111/bju.14012</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0002-3114-9604</orcidid><orcidid>https://orcid.org/0000-0003-0299-489X</orcidid><orcidid>https://orcid.org/0000-0001-5987-3883</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1464-4096 |
| ispartof | BJU international, 2018-01, Vol.121 (1), p.101-110 |
| issn | 1464-4096 1464-410X |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1938851334 |
| source | MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | Analysis of Variance Bladder cancer Blood transfusion Blood Transfusion, Autologous - adverse effects Blood Transfusion, Autologous - methods Blood transfusions Body mass index Cancer Cause of Death Chemotherapy Cohort Studies cystectomy Cystectomy - methods Databases, Factual Disease-Free Survival Europe Female Health risk assessment Humans Kaplan-Meier Estimate Male Mortality Multivariate Analysis Perioperative Care - methods Prognosis Propensity Score Proportional Hazards Models Prospective Studies recurrence Risk Assessment Survival Survival Analysis Tertiary Care Centers Treatment Outcome Tumors Urinary bladder Urinary Bladder Neoplasms - mortality Urinary Bladder Neoplasms - pathology Urinary Bladder Neoplasms - surgery Urinary Bladder Neoplasms - therapy |
| title | Peri‐operative allogeneic blood transfusion does not adversely affect oncological outcomes after radical cystectomy for urinary bladder cancer: a propensity score‐weighted European multicentre study |
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