Blood Storage Duration and Biochemical Recurrence of Cancer After Radical Prostatectomy

Cata, Juan P.; Klein, Eric A.; Hoeltge, Gerald A.; Dalton, Jarrod E.; Mascha, Edward J.; OʼHara, Jerome F.; Russell, Amanda J.; Kurz, Andrea; Ben-Elihayhu, Shamgar; Sessler, Daniel I.

doi:10.4065/mcp.2010.0313

Cited by 21 publications

(17 citation statements)

References 44 publications

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“…This is in agreement with a recent report in prostate cancer patients who were followed for recurrence after prostatectomy. [35] Interestingly, the duration of storage of blood for less than 21 days may be a risk factor for cancer recurrence in patients with colorectal cancer undergoing surgery [36].…”

Section: Discussionmentioning

confidence: 99%

The Impact of Prolonged Storage of Red Blood Cells on Cancer Survival

et al. 2013

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BackgroundThe duration of storage of transfused red blood cells (RBC) has been associated with poor clinical outcomes in some studies. We sought to establish whether prolonged storage of transfused RBC in cancer patients influences overall survival (OS) or cancer recurrence.Methods and FindingsPatients diagnosed with cancer at The Ottawa Regional Cancer Centre between January 01, 2000 and December 31, 2005 were included (n = 27,591) where 1,929 (7.0%) received RBC transfusions within one year from diagnosis. Transfused RBC units were categorized as “new” if stored for less than 14 days, “intermediate” if stored between 14 and 28 days and “old” if stored for more than 28 days. Baseline characteristics between the comparative groups were compared by ANOVA test. Categorical variables and continuous variables were compared using Chi-squared and Wilcoxan rank-sum tests respectively. Overall survival was not associated with duration of storage of transfused RBC with a median survival of 1.2, 1.7, 1.1 years for only new, intermediate and old RBC units respectively (p = 0.36). Cancer recurrence was significantly higher in patients who received a RBC transfusion than those who did not (56.3% vs 33.0% respectively; p<0.0001) but was not affected by the duration of storage of transfused RBC (p = 0.06). In multivariate analysis, lung cancer, advanced stage, chemotherapy, radiation, cancer-related surgery and cancer recurrence were associated with inferior OS (p<0.05), while age, advanced stage, lung cancer, and more than 6 units of blood transfused were associated with cancer recurrence (p<0.05). The duration of storage of RBC before transfusion was not associated with OS or cancer recurrence in multivariate analysis.ConclusionIn patients diagnosed with cancer, the duration of storage of transfused RBC had no impact on OS or cancer recurrence. This suggests that our current RBC storage policy of providing RBC of variable duration of storage for patients with malignancy is safe.

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Section: Discussionmentioning

confidence: 99%

The Impact of Prolonged Storage of Red Blood Cells on Cancer Survival

et al. 2013

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“…7 On the other hand, our group found that storage duration did not affect the incidence of cancer recurrence in patients after prostate surgery. 22 In 405 patients receiving allogeneic transfusions, the biochemical recurrence-free survival rate at 5 yr was 74, 71, and 76% for those who received younger, middle, and older erythrocytes, respectively. 22 Recent data from 526 patients undergoing orthotopic liver transplantation do not show an association between erythrocyte age with infection, organ rejection, and death.…”

Section: Discussionmentioning

confidence: 99%

“…22 In 405 patients receiving allogeneic transfusions, the biochemical recurrence-free survival rate at 5 yr was 74, 71, and 76% for those who received younger, middle, and older erythrocytes, respectively. 22 Recent data from 526 patients undergoing orthotopic liver transplantation do not show an association between erythrocyte age with infection, organ rejection, and death. 29 Over the past 10 yr, storage duration has received most attention in patients undergoing cardiac surgery.…”

Section: Discussionmentioning

confidence: 99%

“…Limited data are available for noncardiac surgical patients. 7,22,23 We thus sought to evaluate whether or not storage duration of transfused erythrocytes is associated with postoperative allcause mortality among noncardiac surgery patients using data derived from the Cleveland Clinic Perioperative Health Documentation System registry.…”

Section: Storage Duration Of Blood and Mortalitymentioning

confidence: 99%

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Erythrocyte Storage Duration Is Not Associated with Increased Mortality in Noncardiac Surgical Patients

Saager

Turan

Dalton³

et al. 2013

Anesthesiology

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Background: More than 5 million patients receive erythrocyte transfusions in the United States every year. Previous studies linked the storage duration of allogeneic erythrocytes to the risk of severe postoperative complications, especially after cardiac or trauma surgery. Limited data are available for noncardiac surgical patients. We therefore evaluated the association between storage duration of transfused erythrocytes and postoperative all-cause mortality among general surgery patients. Methods: Perioperative data corresponding to 63,319 adult, general surgery patients were obtained from our registry and merged with blood product data. Patients receiving solely leukocyte-reduced, allogeneic erythrocyte transfusions were included. Multivariable Cox proportional hazards regression was used to characterize the relationship between median erythrocyte storage duration and postoperative mortality rate, adjusting for characteristics plausibly influencing the storage duration of erythrocytes. Results: Of the 6,994 patients included in the final analysis, 23, 44, 11, 9, and 13% received 1, 2, 3, 4, and ≥5 erythrocyte units, respectively. The authors found no evidence that increasing median storage duration was associated with a difference in the risk of postoperative mortality (hazard ratio, 0.99 [0.94-1.04]; P = 0.64). Analyzing the mean storage duration of erythrocyte units as a function of year of transfusion, the authors demonstrate a relevant decrease in utilization of the oldest blood units, whereas young blood storage duration remains nearly unchanged. Conclusion:The authors' study supports the recent literature in surgical and medical patients and underlines the importance of sufficiently powered randomized trials to finally resolve the erythrocyte storage duration debate.

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“…Ben-Eliyahu and his group found in animal studies that potential immune alterations were due more to erythrocyte storage time, without differences whether blood was leuko-depleted or allogeneic [51], although these results were not supported in human retrospective studies [111,112]. Although there is some evidence suggesting that patients who receive a blood transfusion have a higher risk of tumor recurrence, the data is mainly retrospective in nature.…”

Section: Effects Of Blood Transfusionmentioning

confidence: 56%

Cancer Recurrence and Regional Anesthesia: The Theories, the Data, and the Future in Outcomes

Le-Wendling

Nin

Capdevila³

2016

Pain Med

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Objective. More than one million people each year in the United States are diagnosed with cancer. Surgery is considered curative, but the perioperative phase represents a vulnerable period for residual disease to spread. Regional anesthesia has been proposed to reduce the incidence of recurrence by attenuating the sympathetic nervous system's response during surgery, reducing opioid requirements thus diminishing their immunosuppressant effects, and providing antitumor and antiinflammatory effects directly through systemic local anesthetic action. In this article, we present a description of the perioperative period, a summary of the proposed hypotheses and available literature on the effects of regional anesthesia on cancer recurrence, and put regional anesthesia in context in regard to its potential role in reducing cancer recurrence during the perioperative period.Methods. A literature review was conducted through PubMed by examining the following topics: effects of surgery on tumor progression, roles of multiple perioperative variables (analgesics, hypothermia, blood transfusion, beta-blockade) in cancer recurrence, and available in vitro, animal, and human studies regarding the effects of regional anesthesia on cancer recurrence.Results. in vitro, animal and human retrospective studies suppport the hypothesis that in certain types of cancer, regional anesthesia may be associated with lower recurrence rates. A few well-planned human randomized clinical trials are currently under way that may provide more solid evidence to substantiate or refute the benefits of regional anesthesia in reducing cancer recurrence.Conclusions. The benefits of regional anesthesia in reducing cancer recurrence have a sound theoretical basis and, in certain cancers, are supported by the existing body of literature. This article outlines the current state of our knowledge on the relationship between cancer progression and regional analgesia.

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Blood Storage Duration and Biochemical Recurrence of Cancer After Radical Prostatectomy

Cited by 21 publications

References 44 publications

The Impact of Prolonged Storage of Red Blood Cells on Cancer Survival

The Impact of Prolonged Storage of Red Blood Cells on Cancer Survival

Erythrocyte Storage Duration Is Not Associated with Increased Mortality in Noncardiac Surgical Patients

Cancer Recurrence and Regional Anesthesia: The Theories, the Data, and the Future in Outcomes

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