Table_1_Effect of Perioperative Blood Transfusion on the Postoperative Prognosis of Ruptured Hepatocellular Carcinoma Patients With Different BCLC Stages: A Propensity Score Matching Analysis.pdf

Background and AimThe effect of perioperative blood transfusion (PBT) on the prognosis of patients with ruptured hepatocellular carcinoma (rHCC) with different Barcelona Clinic Liver Cancer (BCLC) stages is not clear. We identified the independent predictors of PBT for postoperative rHCC and investigated the effects of PBT on the prognosis of patients with rHCC at different BCLC stages.MethodsA total of 340 patients who underwent curative hepatectomy for rHCC between January 2010 and March 2018 were abstracted from the databases of two centers. A total of 166 patients underwent PBT. The prognosis of patients who received PBT and those who did not was compared before and after propensity score matching (PSM) in different BCLC stages. Univariate and multivariate Cox regression analyses were also used to identify independent predictors of PBT.ResultsWe divided the 340 patients into two groups: early tumor stage (BCLC-A) n = 196 and advanced tumor stage (BCLC-B/C) n = 144. Overall, the median survival time of the PBT group was lower than that of the nonPBT group before and after PSM. However, in the BCLC-BC group, the prognosis of patients with PBT was not statistically different from that of patients without blood transfusion. Univariate Cox analysis showed that PBT was a risk factor affecting the overall survival (OS) and recurrence-free survival (RFS) in BCLC-A, and PBT was not a risk factor for poor OS and RFS in BCLC-B/C.ConclusionPerioperative blood transfusion has a negative impact on the postoperative prognosis of patients with rHCC in the early stage, but has no significant impact on the postoperative prognosis of patients with rHCC in the advanced stage.

背景与目的：围手术期输血（PBT）对破裂性肝细胞癌（rHCC）患者不同巴塞罗那临床肝癌症（BCLC）分期预后的影响尚不明确。本研究旨在确定围手术期输血对于术后rHCC的独立预测因子，并探讨PBT对不同BCLC阶段rHCC患者预后的影响。方法：从2010年1月至2018年3月期间接受根治性肝切除术的340例rHCC患者中，抽取了来自两个中心的资料。其中，166例患者接受了PBT。通过倾向得分匹配（PSM）在不同BCLC阶段比较了接受PBT与未接受PBT患者的预后。同时，运用单因素和多因素Cox回归分析以识别PBT的独立预测因子。结果：将340例患者分为两组：早期肿瘤阶段（BCLC-A）n = 196和晚期肿瘤阶段（BCLC-B/C）n = 144。总体而言，在PSM前后，PBT组的平均生存时间均低于未接受PBT组。然而，在BCLC-BC组中，接受PBT与未接受输血患者的预后在统计学上无显著差异。单因素Cox分析显示，PBT是影响BCLC-A阶段患者总生存期（OS）和无病生存期（RFS）的风险因素，而在BCLC-B/C阶段，PBT并非影响不良OS和RFS的风险因素。结论：围手术期输血对早期rHCC患者的术后预后产生负面影响，但对晚期rHCC患者的术后预后无显著影响。