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Perioperative allogeneic nonleukoreduced blood transfusion and prostate cancer outcomes after radical prostatectomy
Author(s) -
Yeoh Tze Yeng,
Scavonetto Federica,
Weingarten Toby N.,
Karnes R. Jeffrey,
Buskirk Camille M.,
Hanson Andrew C.,
Schroeder Darrell R.,
Sprung Juraj
Publication year - 2014
Publication title -
transfusion
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.045
H-Index - 132
eISSN - 1537-2995
pISSN - 0041-1132
DOI - 10.1111/trf.12595
Subject(s) - medicine , prostatectomy , prostate cancer , perioperative , blood transfusion , hazard ratio , prostate specific antigen , cancer , proportional hazards model , surgery , confidence interval , urology
Background Allogeneic blood transfusion induces immunosuppression, and concern has been raised that it may increase propensity for cancer recurrence; however, these effects have not been confirmed. We examined the association of perioperative transfusion of allogeneic blood long‐term oncologic outcomes in patients with prostate cancer who underwent prostatectomy. Study Design and Methods We reviewed medical records of patients who underwent radical prostatectomy between 1991 and 2005 and received allogeneic nonleukoreduced blood. Each transfused patient was matched to two controls who did not receive blood: matching included age, surgical year, prostate‐specific antigen level, pathologic tumor stages, pathologic G leason scores, and anesthetic type. Primary outcome was systemic tumor progression, with secondary outcomes of prostate cancer death and all‐cause mortality. Stratified proportional hazards regression analysis was used to assess differences in outcomes between the transfused and nontransfused group. Results A total of 379 prostatectomy patients who were transfused and 758 nontransfused controls were followed for 9.4 and 10.2 years (median), respectively. In a multivariable analysis that took into account the matched study design and adjusted for positive surgical margins and adjuvant therapies, the use of allogeneic blood was not associated with systemic tumor progression (hazard ratio [ HR ], 0.88; 95% confidence interval [ CI ], 0.39‐1.99; p = 0.76), prostate cancer–specific death ( HR , 1.69; 95% CI , 0.44 to 6.48; p = 0.44), or all‐cause death ( HR , 1.20; 95% CI , 0.87 to 1.67; p = 0.27). Conclusions When adjusted for clinicopathologic and procedural variables transfusion of allogeneic blood was not associated with systemic tumor progression and survival outcomes.