Intraoperative autologous blood transfusion use during radical hysterectomy for cervical cancer: Long-term follow-up of a prospective trial
Division of Gynecologic Oncology, University of Iowa Hospitals and Clinics, 200 Hawkins Drive 4630 JCP, Iowa City, IA 52242, USA. Archives of Gynecology
(Impact Factor: 1.36).
05/2012; 286(3):717-21. DOI: 10.1007/s00404-012-2351-1
A primary operative complication of radical hysterectomy for cervical cancer is hemorrhage. Intraoperative autologous blood transfusion (ABT) may be beneficial in reducing the need for homologous blood transfusion.
Our institution published a prospective cohort study examining the use of ABT in cervical cancer patients undergoing radical hysterectomy in 1995. Patients who were initially consented to participate in this prospective trial using intraoperative ABT (cell saver) were evaluated with a median follow-up of 3 years. We sought to update this original report with 16-year follow-up data collected from the clinical charts, Tumor Registry, and the Social Security Death Index.
Two groups of patients undergoing radical hysterectomy were compared: patients who received ABT, and those who did not. Of the 71 original patients, all were included in this updated review, with an average follow-up of 12.4 years for both groups. Originally, thirty-one patients received an ABT. In this group, 1 patient was lost to follow-up, and 4 (12.9 %) are deceased including 1 (3 %) with disease. In the non-autologous group, there were 7 (17.5 %) patient deaths, including 3 (7.5 %) with disease. Eighty-three percent were alive after 12 years in both groups. The ABT group had 1 patient (3 %) who developed a secondary malignancy, a colon adenocarcinoma. The non-autologous group had 2 patients (5 %) who developed a secondary malignancy; one patient developed multiple myeloma and one patient developed a verrucous cancer of the tongue.
Autologous blood transfusion during radical hysterectomy for cervical cancer appears safe and effective.
Available from: Zubia Mumtaz
Available from: Volkan Ince
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ABSTRACT: To investigate the therapeutic efficacy and safety of continuous autotransfusion system (CATS) during liver transplantation of hepatocellular carcinoma patients.
Eighty-three hepatocellular carcinoma (HCC) patients who underwent liver transplantation with intraoperative CATS (n = 24, CATS group) and without (n = 59, non-CATS group) between April 2006 and November 2011 at the Liver Transplant Institute of Inonu University were analyzed retrospectively. Postoperative HCC recurrence was monitored by measuring alpha-fetoprotein (AFP) levels at 3-mo intervals and performing imaging analysis by thoracoabdominal multidetector computed tomography at 6-month intervals. Inter-group differences in recurrence and correlations between demographic, clinical, and pathological data were assessed by ANOVA and χ(2) tests. Overall and disease-free survivals were calculated by the univariate Kaplan-Meier method.
Of the 83 liver transplanted HCC patients, 89.2% were male and the overall mean age was 51.3 ± 8.9 years (range: 18-69 years). The CATS and non-CATS groups showed no statistically significant differences in age, sex ratio, body mass index, underlying disease, donor type, graft-to-recipient weight ratio, Child-Pugh and Model for End-Stage Liver Disease scores, number of tumors, tumor size, AFP level, Milan and University of California San Francisco selection criteria, tumor differentiation, macrovascular invasion, median hospital stay, recurrence rate, recurrence site, or mortality rate. The mean follow-up time of the non-CATS group was 17.9 ± 12.8 mo, during which systemic metastasis and/or locoregional recurrence developed in 25.4% of the patients. The mean follow-up time for the CATS group was 25.8 ± 15.1 mo, during which systemic metastasis and/or locoregional recurrence was detected in 29.2% of the patients. There was no significant difference between the CATS and non-CATS groups in recurrence rate or site. Additionally, no significant differences existed between the groups in overall or disease-free survival.
CATS is a safe procedure and may decrease the risk of tumor recurrence in HCC patients.
Available from: Khadra Galaal
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ABSTRACT: Background: Cytoreductive surgery for ovarian cancer is often an extensive procedure, associated with substantial intraoperative blood loss. Blood lost during surgery is conventionally replaced using donor (allogeneic) blood. Intra-operative cell salvage may be an alternative, suggested to improve outcomes in terms of morbidity and survival.
Objectives: To compare the safety of intraoperative cell salvage (IOCS) vs. allogeneic blood transfusion in women undergoing surgery for ovarian cancer in terms of overall and disease free survival.
Methods: We performed a systematic search of Medline, the four full text collections (Science Direct, Ingenta Select, Ovid full text and Wiley Interscience) from 1966 until Jan 2014.The Cochrane Gynaecological Cancer Collaborative Review Group’s Trial Register was also searched. For databases other than Medline, the search strategy had been adapted accordingly. In addition we searched abstracts of scientific meetings and reference lists of review articles. Two review authors independently assessed whether potentially relevant studies met the inclusion criteria.
Results: The search strategy identified 18 unique references of which 15 were excluded on the basis of title and abstract. The remaining 3 articles were retrieved in full, but none satisfied the inclusion criteria. No studies comparing intraoperative cell salvage vs. blood transfusion were identified.
Authors’ conclusions: We found no comparative studies assessing the overall and disease free survival for intraoperative cell salvage versus allogeneic blood transfusion in women undergoing surgery for ovarian cancer. Based on the findings in other tumour sites, a randomised controlled trial is needed to compare intraoperative cell salvage and allogeneic transfusion for women with ovarian cancer.
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