The effect of intraoperative transfusion on the prognosis in hepatectomized hepatocellular carcinoma patients

Lee, Kwang Woong; Suh, Kyung Suk; Roh, Hye Rin; Koh, Young Taeg; Lee, Kuhn Uk

Abstract

BACKGROUND/AIMS: There are many reports in which perioperative transfusion was closely related to the survival of cancer. The long-term survival rate of patients with hepatocellular carcinoma undergoing hepatectomy has improved, and it may be related to the reduction of intraoperative transfusion. The aim of this study is to evaluate the effect of intraoperative transfusion on the prognosis in the hepatectomized hepatocellular carcinoma patients and the relationship between the survival improvement and reduction of intraoperative transfusion.
METHODS
From 1988 Jan. to 1995 Dec., 507 cases in which the amount of intraoperative transfusion was known were reviewed. Operative transfusion of whole blood or packed red cells was included in this study. The clinical, operative, and pathological factors were analyzed to identify factors that affected long-term survival and disease free survival.
RESULTS
By multivariate analysis, Child classification, the extent of resection, portal vein invasion, and blood transfusion(more than 7 units) were shown to be independent factors in overall survival. Child classification, the number of tumors, portal vein invasion, and blood transfusion(more than 7 units) were shown to be independent factors in disease free survival.
CONCLUSION
Operative blood transfusion affects the long-term survival and the disease free survival. Therefore, the intraoperative transfusion should be reduced if possible. Through the improvement of surgical technique and instrument, surgeon can reduce the intraoperative bleeding, and this reduction of intraoperative bleeding may contribute the improvement of survival through the reduction of intraoperative transfusion.