Survival advantage of using autologous blood transfusion during surgery for esophageal cancer.
ABSTRACT There is evidence that blood transfusion is associated with an increased rate of tumor recurrence. This study was conducted to assess the survival advantage of giving autologous blood instead of allogeneic blood during surgery for esophageal cancer.
We retrospectively analyzed 62 patients who underwent esophagectomy for thoracic esophageal cancer between January 1991 and February 1995 and received allogeneic blood transfusion, and 61 patients operated on between March 1995 and February 1998, who received autologous blood transfusion. The clinicopathological factors and survival rates were compared between the two groups.
The clinicopathological factors that influenced prognosis were similar in the two groups; however, a definite survival advantage was evident in the autologous blood transfusion group. According to multivariate analyses, the transfusion of allogeneic blood was an independent prognostic factor ( P = 0.0222), as was the presence of metastatic lymph nodes. Patients who received allogeneic blood transfusions perioperatively had more than a twofold greater risk (Hazard ration 2.406) of death over patients who received autologous blood transfusions.
Autologous blood transfusion appears to be an independent prognostic factor for the survival of patients with esophageal cancer.
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ABSTRACT: The aim of this retrospective study was to analyze the effects of perioperative blood transfusion during radical hysterectomy with lymph node dissection on the prognosis of cervical cancer stage Ib. A total of 295 patients who had undergone surgery from 1987-2002 were included. Forty seven patients underwent conization before definite surgery, and 2 patients were subsequently lost to follow up. Among the remaining 246 patients, 97 received allogenic blood transfusion, 38 received autologous blood transfusion, and 111 received no transfusion. The clinicopathologic finding of these three groups were reviewed and analyzed. There was no significant difference among three groups in age, chief complaints, duration of symptoms, size of lesion, histopathology, grade, margin or parametrium involvement, node status or postoperative adjuvant treatment. The most prominent presenting symptoms were abnormal vaginal discharge, abnormal vaginal bleeding, and postcoital bleeding. Although the 5-year disease-free survival (DFS) (and 95% CI) for autologous blood transfused group was 90.9% (74.4-97.0%), falling to 88.1% (77.8-93.8%) in untransfused blood group and 81.7% (71.3-88.6%) in allogenic transfused blood group, there were no significant differences among three groups (P = 0.699). In multivariate analyses, only age (P = 0.046), size of lesion (P = 0.024) and histology (P = 0.046) were statistically significantly associated with DFS, whereas transfusion status was not. In conclusion, there is no evidence that perioperative blood transfusion affects DFS of patients undergoing radical hysterectomy and pelvic lymphadenectomy. Only age, size of lesion and histology were statistically significantly associated with DFS.Asian Pacific journal of cancer prevention: APJCP 8(4):476-80. · 2.51 Impact Factor
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ABSTRACT: Im Sinne des Qualitätsmanagements ist die Überwachung von Transfusionen gefordert. Ziel war die Ermittlung der Transfusionsfrequenz und die Identifikation von Risiko- und Schutzfaktoren bei der operativen Therapie von Plattenepithelkarzinomen der Mundhöhle. 150 Akten wurden retrospektiv untersucht und ein Teil durch eine logistische Regression weiter ausgewertet. Die Gesamttransfusionsrate lag bei 55%, die der Erythrozytenkonzentrate bei 51,1%. Im hiesigen Patientenkollektiv stellten sich eine lange OP-Dauer, eine Unterkieferteilresektion und das männliche Geschlecht als steigerndes Risiko für eine Transfusion dar. Ein hoher HKT, eine Oberkieferbeteiligung und eine lange PTT reduzierten das Risiko. Die Studie zeigt, dass Richtlinien zur gezielten präoperativen Bereitstellung von Konserven überarbeitet werden müssen, um Kosten zu senken und um den Schutz der Patienten zu gewährleisten.
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ABSTRACT: The mechanism underlying the immunomodulation caused by blood transfusion has yet to be elucidated. The aim of the present study was to determine whether the transfusion of a soluble or insoluble factor present in stored blood can induce immunomodulation, which would thereby promote solid tumor growth. C57Bl/6J mice were subcutaneously inoculated with B16-CG melanoma cells, which secrete beta-human chorionic gonadotropin (beta-hCG). Following inoculation, each of three different products of allogeneic and syngeneic blood were transfused on days 0 and 1: fresh whole blood, stored whole blood, and supernatants from the stored blood. Tumor growth was then monitored by measuring urinary beta-hCG. All mice were killed on day 15, and the tumor weight and volume were measured. Transfusion of all allogeneic blood products enhanced tumor growth, as did the stored syngeneic whole blood. Neither fresh syngeneic blood nor the supernatant from stored syngeneic blood promoted tumor growth. Although the tumors were not visually detectable until day 10 after inoculation, by day 7 the levels of urinary beta-hCG were significantly higher in the mice that received allogeneic blood supernatant than in the mice that received saline. A soluble alloantigen enhances solid tumor growth, as does an insoluble factor present in stored syngeneic whole blood. The immunomodulation associated with this factor begins to enhance tumor growth within 7 days after transfusion.Surgery Today 02/2004; 34(8):673-7. DOI:10.1007/s00595-004-2801-x · 1.21 Impact Factor