The use of cell salvage during radical retropubic prostatectomy: does it influence cancer recurrence?

Abstract

blood using a commercial cell saver; 264 receiving only autologous transfusion; and 57 with no transfusion. Disease recurrence was defined as a prostate-specific antigen (PSA) level of >0.2 ng/mL. Bivariate and multivariate logistic regression analyses were used to assess and compare the risk of cancer recurrence in the three groups. Covariates used in the multivariate analyses included Gleason score, preoperative PSA level, seminal vesicle involvement and surgical margins. RESULTSThe mean (range) follow-up was 40.2 (12-104) months; there were no significant differences among the groups in initial PSA level and Gleason score. In the multivariate logistic regression analysis, the initial PSA, Gleason score, seminal vesicle involvement and surgical margins, but not transfusion group, were independent predictors of recurrence. CONCLUSIONCell salvage during RRP does not influence the recurrence of prostate cancer. Cell salvage is a safe method of transfusion during RRP.

Use of a leucocyte filter to remove tumour cells from intra‐operative cell salvage blood

“…All the in-vivo evidence has shown that cancer patients receiving cell salvaged blood do not get increased rates of recurrences or increased mortality, and there has been considerable clinical use of cell salvage in all types of cancer surgeryparticularly urology, over the last 20 years. Up to 2003 the evidence consisted of a small number of case reports and observational studies [51][52][53][54][55][56][57][58][59], and has been criticised as a result [50]. However, they do show no difference in recurrence rate with intra-operative cell salvage or a better outcome compared with allogeneic transfusion.…”

Red‐cell salvage in urological surgery

“…It is generally accepted that the presence of seminal vesicle invasion (SVI) in a resected specimen is an unfavourable prognostic factor in prostate cancer [1][2][3]. SVI has been reported in 5-13.6% of recent radical prostatectomy specimens [4][5][6]. Various studies have assessed the prediction of recurrence and prognosis in patients with prostate cancer and SVI treated by radical prostatectomy.…”

Blood transfusion and hemostatic agents used during radical cystectomy

“…16,17 Lastly, autologous blood recovery (CellSaver) is the reinfusion of blood lost during the operation, which is collected, filtered, washed, processed and re-transfused, but is controversial among urologists due to theoretical risks of cancer dissemination. 16,18 Interestingly, experienced urologists use these techniques more commonly than less experienced surgeons. The reasons for this association are unknown.…”