ORIGINAL ARTICLE Perioperative Blood Transfusion as a Poor Prognostic Factor After Aggressive Surgical Resection

# 2015 The Author(s). This article is published with open access at Springerlink.com Background Blood transfusion is linked to a negative outcome for malignant tumors. The aim of this study was to evaluate aggressive surgical resection for hilar cholangiocarcinoma (HCCA) and assess the impact of perioperative blood transfusion on long-term survival. Methods Sixty-six consecutive major hepatectomies with en bloc resection of the caudate lobe and extrahepatic bile duct for HCCAwere performed using macroscopically curative resection at our institute from 2002 to 2012. Clinicopathologic factors for recurrence and survival were retrospectively assessed. Results Overall survival rates at 1, 3, and 5 years were 86.7, 47.3, and 35.7 %, respectively. In univariate analysis, perioperative blood transfusion and a histological positive margin were two of several variables found to be significant prognostic factors for recurrence or survival (P<0.05). In multivariate analysis, only perioperative blood transfusion was independently associated with recurrence (hazard ratio (HR)=2.839 (95 % confidence interval (CI), 1.370–5.884), P=0.005), while perioperative blood trans-fusion (HR=3.383 (95 % CI, 1.499–7.637), P=0.003) and R1 resection (HR=3.125 (95 % CI, 1.025–9.530), P=0.045) were independent risk factors for poor survival. Conclusions Perioperative blood transfusion is a strong predictor of poor survival after radical hepatectomy for HCCA.We suggest that circumvention of perioperative blood transfusion can play an important role in long-term survival for patients with HCCA