Influence of blood transfusions during radical retropubic prostatectomy on disease outcome

Paul, R.; Schmid, Roland M.; Busch, Raymonde; Randenborgh, H. Van; Alschibaja, M.; Schöler, S.; Härtung, R.

doi:10.1016/j.urology.2005.07.020

Cited by 30 publications

(39 citation statements)

References 16 publications

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“…The main finding of our study was a lack of an association between allogeneic BT during radical retropubic prostatectomy for prostate cancer and systemic tumor progression, prostate cancer death, or all‐cause death. These findings are in agreement with several previous studies;7,11‐15 however, our study is the first to account for immunomodulatory effects of anesthetic technique…”

Section: Discussionsupporting

confidence: 94%

“…Several studies investigated the role of TRIM in colorectal cancers with a recent meta‐analysis of 55 studies concluding that perioperative allogeneic BT increased the risk of cancer‐related and all‐cause death after colorectal cancer surgery . Several retrospective studies examined the role of perioperative BT on oncologic outcomes after prostate cancer surgery 7,11‐18…”

mentioning

confidence: 99%

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Perioperative allogeneic nonleukoreduced blood transfusion and prostate cancer outcomes after radical prostatectomy

et al. 2014

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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 Gleason 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 allcause 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.

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Section: Discussionsupporting

confidence: 94%

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confidence: 99%

Perioperative allogeneic nonleukoreduced blood transfusion and prostate cancer outcomes after radical prostatectomy

et al. 2014

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“…Third, we found that a large percentage of patients underwent transfusion in the perioperative period. A similar rate of transfusion was reported by Paul et al, 44 who found that 56.7% of the patients undergoing retropubic radical prostatectomy received transfusions intraoperatively or postoperatively. However, a study from Mayo Clinic demonstrated that the rate of transfusion was strikingly smaller than ours; therefore, our results may not be applicable across other academic centers.…”

Section: Discussionsupporting

confidence: 84%

Blood Storage Duration and Biochemical Recurrence of Cancer After Radical Prostatectomy

Cata

Klein

Hoeltge

et al. 2011

Mayo Clinic Proceedings

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“…This could be attributed to the surgical technique as these happen to be the early series in a learning curve as well as limited experience of the anaesthetic team in the procedure of radical retropubic prostatectomy. A defined transfusion trigger can help reduce this rate of transfusion as was observed in a reported retrospective study with transfusion rate being 88.9% in 1988 and dropping to 9.1% in 2002 [13]. …”

Section: Discussionmentioning

confidence: 99%

Outcomes after Radical Prostatectomy in Ghanaians: A Surgeon's Early Experience

et al. 2013

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Background. There is a lack of expertise in the procedure of open radical retropubic prostatectomy in West Africa therefore necessitating the training of urologists in the subregion in this procedure. Aim. This report looks at the early outcomes of a single surgeon in this procedure after an SIU fellowship. Methodology. A prospective study of the initial twenty consecutive patients with clinically localized prostate cancer that underwent open radical retropubic prostatectomy at the Korle Bu Teaching hospital, Accra. Results. The mean followup was 19.5 months (range 7 months–36 months). The mean age was 62.7 yrs. For the clinical stage, 60% were T1c and 40% T2a with a mean Gleason score of 6.5. The mean estimated blood loss was 1140.0 mLs with a transfusion rate of 70%. For the pathologic stage, pT2 cancers formed 60%, pT3 25%, and pT4 5% with a mean Gleason score of 6.8. No lymph node involvement was noted. The perioperative complications rate was 15%, a postoperative potency recovery rate of 78.6% with all the patients being continent of urine. The tPSA of 95% of the patients had remained less than 0.4 ng/mL. Conclusion. The SIU scholarship offers an avenue for training in radical prostatectomy for sub-Saharan Africa.

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Influence of blood transfusions during radical retropubic prostatectomy on disease outcome

Cited by 30 publications

References 16 publications

Perioperative allogeneic nonleukoreduced blood transfusion and prostate cancer outcomes after radical prostatectomy

Perioperative allogeneic nonleukoreduced blood transfusion and prostate cancer outcomes after radical prostatectomy

Blood Storage Duration and Biochemical Recurrence of Cancer After Radical Prostatectomy

Outcomes after Radical Prostatectomy in Ghanaians: A Surgeon's Early Experience

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