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Do perioperative blood transfusions impact oncological outcomes of robot-assisted radical cystectomy with intracorporeal urinary diversion? Results from a large multi-institutional registry.
Sarkis, Julien; Diamand, Romain; Aoun, Fouad; Assenmacher, Gregoire; Assenmacher, Christophe; Verhoest, Gregory; Holz, Serge; Naudin, Michel; Ploussard, Guillaume; Mari, Andrea; Minervini, Andrea; Tay, Andrea; Issa, Rami; Roumiguié, Mathieu; Bajeot, Anne S; Simone, Giuseppe; Anceschi, Umberto; Umari, Paolo; Sridhar, Ashwin; Kelly, John; Hendricksen, Kees; Einerhand, Sarah; Mertens, Laura S; Sanchez-Salas, Rafael; Colomer, Anna; Quackels, Thierry; Peltier, Alexandre; Montorsi, Francesco; Briganti, Alberto; Pradere, Benjamin; Moschini, Marco; Roumeguère, Thierry; Albisinni, Simone.
Afiliação
  • Sarkis J; Department of Urology, Erasme Hospital, University Clinics of Brussels, Université Libre de Bruxelles, Brussels, Belgium - Juliensarkis@live.com.
  • Diamand R; Department of Urology, Jules Bordet Institute, Université Libre de Bruxelles, Brussels, Belgium.
  • Aoun F; Department of Urology, Hotel Dieu de France, Beirut, Lebanon.
  • Assenmacher G; Department of Urology, Cliniques de l'Europe-Saint Elisabeth, Brussels, Belgium.
  • Assenmacher C; Department of Urology, Cliniques de l'Europe-Saint Elisabeth, Brussels, Belgium.
  • Verhoest G; Department of Urology, CHU Rennes, Rennes, France.
  • Holz S; Department of Urology, CHU Ambroise Paré, Mons, Belgium.
  • Naudin M; Department of Urology, CHU Ambroise Paré, Mons, Belgium.
  • Ploussard G; Department of Urology, La Croix du Sud Hospital, Quint-Fonsegrives, France.
  • Mari A; Institut Universitaire du Cancer Toulouse - Oncopole, Toulouse, France.
  • Minervini A; Department of Experimental and Clinical Medicine, Unit of Oncologic Minimally-Invasive Urology and Andrology, Careggi University Hospital, University of Florence, Florence, Italy.
  • Tay A; Department of Experimental and Clinical Medicine, Unit of Oncologic Minimally-Invasive Urology and Andrology, Careggi University Hospital, University of Florence, Florence, Italy.
  • Issa R; Department of Urology, Saint Georges Hospital, London, UK.
  • Roumiguié M; Department of Urology, Saint Georges Hospital, London, UK.
  • Bajeot AS; Department of Urology, Andrology and Renal Transplantation, CHU Rangueil, Paul-Sabatier University, Toulouse Cedex, France.
  • Simone G; Department of Urology, Andrology and Renal Transplantation, CHU Rangueil, Paul-Sabatier University, Toulouse Cedex, France.
  • Anceschi U; Department of Urology, IRCCS Regina Elena National Cancer Institute, Rome, Italy.
  • Umari P; Department of Urology, IRCCS Regina Elena National Cancer Institute, Rome, Italy.
  • Sridhar A; Division of Surgery and Interventional Sciences, University College of London, London, UK.
  • Kelly J; Division of Surgery and Interventional Sciences, University College of London, London, UK.
  • Hendricksen K; Division of Surgery and Interventional Sciences, University College of London, London, UK.
  • Einerhand S; Department of Urology, Netherlands Cancer Institute, Amsterdam, the Netherlands.
  • Mertens LS; Department of Urology, Netherlands Cancer Institute, Amsterdam, the Netherlands.
  • Sanchez-Salas R; Department of Urology, Netherlands Cancer Institute, Amsterdam, the Netherlands.
  • Colomer A; Department of Urology, Montsouris Mutualiste Institute, Paris, France.
  • Quackels T; Department of Urology, Montsouris Mutualiste Institute, Paris, France.
  • Peltier A; Department of Urology, Erasme Hospital, University Clinics of Brussels, Université Libre de Bruxelles, Brussels, Belgium.
  • Montorsi F; Department of Urology, Jules Bordet Institute, Université Libre de Bruxelles, Brussels, Belgium.
  • Briganti A; Division of Oncology, Unit of Urology, Urological Research Institute, IRCCS San Raffaele Hospital, Vita-Salute San Raffaele University, Milan, Italy.
  • Pradere B; Division of Oncology, Unit of Urology, Urological Research Institute, IRCCS San Raffaele Hospital, Vita-Salute San Raffaele University, Milan, Italy.
  • Moschini M; Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.
  • Roumeguère T; Department of Urology UROSUD, Croix Du Sud Hospital, Quint-Fonsegrives, France.
  • Albisinni S; Division of Oncology, Unit of Urology, Urological Research Institute, IRCCS San Raffaele Hospital, Vita-Salute San Raffaele University, Milan, Italy.
Minerva Urol Nephrol ; 75(1): 50-58, 2023 Feb.
Article em En | MEDLINE | ID: mdl-36800680
ABSTRACT

BACKGROUND:

Blood transfusions (BT) have been associated with adverse oncologic outcomes in multiple malignancies including open radical cystectomy (ORC) for urothelial carcinoma of the bladder (UCB). Robot-assisted radical cystectomy (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 institutions, 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 univariate 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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Texto completo: 1 Bases de dados: MEDLINE Assunto principal: Derivação Urinária / Neoplasias da Bexiga Urinária / Robótica / Carcinoma de Células de Transição / Procedimentos Cirúrgicos Robóticos Tipo de estudo: Clinical_trials Limite: Humans Idioma: En Revista: Minerva Urol Nephrol Ano de publicação: 2023 Tipo de documento: Article
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Bases de dados: MEDLINE Assunto principal: Derivação Urinária / Neoplasias da Bexiga Urinária / Robótica / Carcinoma de Células de Transição / Procedimentos Cirúrgicos Robóticos Tipo de estudo: Clinical_trials Limite: Humans Idioma: En Revista: Minerva Urol Nephrol Ano de publicação: 2023 Tipo de documento: Article