gms | German Medical Science

Objective: Recent evidence suggests that transfusion of allogeneic red blood cells (RBCT) may impose negative effects on patients with various cancers. Thus, efforts are being made to limit RBCT in the clinical setting. RBCT is associated with higher rates of surgical complications and all-cause mortality in patients undergoing colorectal cancer surgery. RBCT is thought to negatively influence the metastatic rate and the survival of patients undergoing cystectomy for bladder cancer. Comparable data regarding the effect of RBCT on patients with primary glioblastoma (GBM) are lacking.

Method: We retrospectively analyzed our institutional database of brain tumor patients for clinical patient data in a consecutive patient series. We performed uni- and multivariate analyses to identify factors potentially influencing the necessity for RBCT and to elucidate the effect of RBCT on patient survival.

Results: We analyzed 151 consecutive patients with histologically proven GBM, who underwent craniotomy and tumor resection before adjuvant first-line therapy. Median age was 61 years (range: 23-84 years), median KPS was (range: 40-100) and median overall survival was 18.2 months (range: 0.4-61.0 months). 92 patients (60.9%) had radiologically complete resections, 59 (39.1%) had subtotal resections only. Perioperative RBCT was performed in 16 patients (10.6%). Following uni- and multivariate analyses, patient ASA score (>or=3) and intraoperative blood loss (>or=475ml) were independent predictors for RBCT (p<0.05 for both). When analyzing survival, there were no significant differences between patients, who had and who did not have RBCT (18.1 vs. 18.2 months, p=0.38). Multivariate Cox regression analysis showed that patient age, MGMT-promotor methylation status, extent of tumor resection, and completion of the Stupp-protocol were independent factors influencing overall survival.

Conclusions: A large proportion of patients undergoing tumor resection of GBM needs RBCT. In contrast to other solid cancers, perioperative RBCT appears to have no negative influence on patient prognosis in GBM.