Survival Advantage of Using Autologous Blood Transfusion During Surgery for Esophageal Cancer

Department of Public Health, Akita University, Akita, Akita, Japan
Surgery Today (Impact Factor: 1.53). 02/2002; 32(11):951-8. DOI: 10.1007/s005950200191
Source: PubMed


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.

5 Reads
  • Source
    [Show abstract] [Hide abstract]
    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.
    Preview · Article ·
  • [Show abstract] [Hide abstract]
    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.
    No preview · Article · Feb 2004 · Surgery Today
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Cancer-related anemia occurs in more than 50% of patients with malignancies and constitutes a common finding in patients with gastrointestinal tract tumors. In the present article we present the possible pathogenetic mechanisms as well as the appropriate clinical and laboratory investigations for the anemia, which is associated with gastrointestinal tract malignancies. Moreover, we conducted a MEDLINE database search between 1992- 2003, focusing on the currently available methods for perioperative correction and treatment of anemia. The currently available evidence suggests that perioperative allogenic blood transfusion is associated with increased rates of postoperative infections and constitutes an independent adverse prognostic factor in gastrointestinal malignancies; autologous blood transfusions are of no clinical benefit compared to allogenic transfusions, as autologous blood is not immunologically neutral; and the shortterm results of erythropoietin (EPO) use remain controversial, while its long-term results remain unknown. Correction of anemia in every patient with resectable gastrointestinal malignancy is mandatory, because it improves surgical stress response, wound healing process and quality of life. Although EPO administration constitutes the treatment of choice for patients receiving chemotherapy and/ or radiotherapy, the best perioperative method for anemia correction remains unknown and further prospective randomized studies are required. From the surgical point of view, any effort for "bloodless surgery" should be attempted.
    Full-text · Article · Jul 2004 · Journal of B.U.ON.: official journal of the Balkan Union of Oncology
Show more