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: To investigate whether fresh frozen plasma (FFP) transfusion affects outcomes following hepatic resection for hepatocellular carcinoma (HCC) in terms of liver function, postoperative complications and cancer prognosis. We retrospectively compared the incidence of postoperative complications between 204 patients who underwent hepatectomy for HCC with routine FFP transfusion in an early period (1983-1993, Group A) and 293 with necessity for FFP transfusion during a later period (1998-2006, Group B), and also between two subgroups of Group B [22 patients with FFP transfusion (Group B1) and 275 patients without FFP transfusion (Group B2)]. Additionally, only in limited patients in Group B1 and Group B2 with intraoperative blood loss ≥ 2000 mL (Group B1(≥ 2000 mL) and Group B2(≥ 2000 mL)), postoperative complications, liver function tests, and cancer prognosis were compared. No mortality was registered in Group B, compared to 8 patients (3.9%) of Group A. The incidence of morbidity in Group B2 [23.2% (64/275)] was not significantly different from Group B1 [40.9% (9/22)] and Group A [27.0% (55/204)]. The incidence of complications and postoperative liver function tests were comparable between Group B1(≥ 2000 mL) vs Group B2(≥ 2000 mL). Postoperative prognosis did not correlate with administration of FFP, but with tumor-related factors. The outcome of hepatectomy for HCC is not influenced by FFP transfusion. We suggest FFP transfusion be abandoned in patients who undergo hepatectomy for HCC.World Journal of Gastroenterology 11/2010; 16(44):5603-10. · 2.55 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: A substantial body of evidence suggests that allogeneic blood transfusion increases the rate of recurrence of resected malignancies. The present study was conducted with the aim of understanding better the clinical characteristics of recurrent esophageal cancer and determining whether any survival advantage is conferred by transfusing autologous instead of allogeneic blood during the esophagectomy for the original malignancy. We retrospectively analyzed 123 patients who received blood transfusion while undergoing esophagectomy for thoracic esophageal cancer between January 1991 and February 1998. We focused on those patients in whom the malignancy recurred. Of them, 23 patients received allogeneic blood and 18 received autologous blood. Compared were the clinico-pathological factors influencing prognosis as well as the disease-free survival periods and the period of survival after recurrence of the cancer. The clinico-pathological factors that influenced prognosis were similar in the two groups. There was also no significant difference in the rate at which the esophageal cancer recurred, or in survival time once it had recurred. On the other hand, disease-free survival prior to recurrence was significantly prolonged in the autologous blood transfusion group. Use of autologous instead of allogeneic blood prolongs disease-free survival of esophageal cancer patients.Journal of Surgical Oncology 08/2004; 87(1):26-31. · 2.64 Impact Factor