The impact of perioperative blood transfusion on survival and recurrence after radical prostatectomy for prostate cancer: A systematic review and meta-analysis

Objective: Conflicting data have been reported regarding the association between perioperative blood transfusion (PBT) and clinical outcomes for prostate cancer patients. We conducted a systematic review and meta-analysis to evaluate the impact of PBT on cancer survival and recurrence for patients who underwent radical prostatectomy (RP). Methods: A systematic review of PubMed, EMBASE, and Cochrane libraries was performed to identify all eligible studies that evaluate the association between PBT and clinical outcomes for prostate cancer patients undergoing RP. The analyzed outcomes were overall survival (OS) and recurrence-free survival (RFS) at 3, 5, and 10 years. Results: A total of eight articles met our criteria. Meta-analysis indicated that prostate cancer patients with PBT had decreased OS (hazard ratio [HR] = 1.51, 95% confidence interval [CI], 1.22- 1.85, P < 0.01; HR = 1.57, 95% CI, 1.33- 1.85, P < 0.01; HR = 1.55, 95% CI, 1.03- 2.33, P = 0.04) and RFS (HR = 1.67, 95% CI, 1.37- 2.04, P < 0.01; HR = 1.42, 95% CI, 1.23- 1.63, P < 0.01; HR = 1.37, 95% CI, 1.03- 1.83, P = 0.03) at 3, 5, and 10 years after surgery compared with those without PBT. Conclusions: The findings from the current meta-analysis demonstrate that PBT was associated with adverse survival and recurrence outcomes for prostate cancer patients undergoing RP.