No impact of perioperative blood transfusion on prognosis after curative resection for hepatocellular carcinoma: a propensity score matching analysis.

BACKGROUND: The relationship between perioperative blood transfusion and long-term survival after curative resection for hepatocellular carcinoma (HCC) remains controversial. The aim of the present study was to investigate the impact of blood transfusion on the long-term prognosis of HCC patients.

METHODS: Patients with primary HCC who underwent a curative hepatectomy from 2003 to 2011 were enrolled and then retrospectively studied. The clinicopathologic characteristics between patients in the blood transfusion and non-transfusion groups were matched using a propensity score matching (PSM) analysis. Univariate and multivariate Cox regression analyses were used to identify whether perioperative blood transfusion affects long-term survival after resection for HCC.

RESULTS: A total of 374 patients were enrolled and 113 patients received perioperative transfusions. The 1-, 3- and 5-year disease-free and overall survival rates of the entire cohort were 65.0, 37.3 and 23.9%, and 90.9, 70.7 and 57.5%, respectively. The disease-free and overall survival rates of the blood transfusion group were significantly worse than the disease-free and overall survival rates of the non-transfusion group in the entire cohort (p < 0.001, p < 0.001). However, the differences in the survival rates between the two groups were no longer significant after PSM (p = 0.067, p = 0.105). Multivariate Cox analyses showed that perioperative blood transfusion was not an independent predictor of disease-free and overall survival in the propensity-matched cohort (p = 0.154, p = 0.667).

CONCLUSIONS: The present study demonstrates that perioperative blood transfusion has no impact on disease-free and overall survival after curative resection for HCC.