The association between transfusion and cancer‐free survival after curative resection for hepatocellular carcinoma

Abstract

Background. In cases of surgery for hepatocellular carcinoma (HCC), postoperative intrahepatic recurrence is the main obstacle to long‐term survival of patients. The association between perioperative transfusion and recurrence‐free survival was studied in 126 patients with HCC who underwent hepatic resection between 1985 and 1990 and in whom complete follow‐up information was available until 1992. Methods. Patients who received neither whole blood nor packed erythrocytes during hospitalization formed the no transfusion group (n = 72), and the remaining patients who were given either whole blood or packed erythrocytes during hospitalization constituted the transfusion group (n = 54). Results. The 1‐year, 3‐year, and 5‐year recurrence‐free survival rates of the nontransfused versus transfused groups were 80.6% versus 74.1%, 50.9% versus 33.4%, and 37.1% versus 26.2%, respectively (P = 0.1590). After adjustment for other covariates, the serum albumin level and histological intrahepatic metastasis (im) remained as significant variables for recurrence‐free survival. Although there was no association between the erythrocyte transfusion and the recurrence‐free survival of the patients with serum albumin levels either more than 3.5 g/dl or less than or equal to 3.5 g/dl, the 1‐year, 3‐year, and 5‐year recurrence‐free survival rates of the nontransfused versus transfused groups of the patients with im‐negative HCC were 92.2% versus 80.0%, 62.6% versus 36.3%, and 47.4% versus 27.1%, respectively (P = 0.0254). Conclusions. The association between erythrocyte transfusion and the recurrence‐free survival was recognized only in patients with im‐negative HCC. Copyright © 1993 American Cancer Society