Blood transfusion and laryngeal cancer

Evidence exists to suggest a detrimental effect of blood transfusion on survival after resection for malignant disease. Immune suppression due to transfusion has been implicated, though this remains unproven. We have conducted a retrospective study of 69 patients (38 transfused, 31 not transfused) with squamous carcinoma of the larynx to assess the effect of blood transfusion on survival after laryngectomy. Patients were compared for age, sex, smoking habit, tumour site and stage, grade of operating surgeon, preoperative haemoglobin, tumour nucleolar organizer region status, and operation time. The minimum follow-up was 5 years. In the transfused group 21/38 died as a result of their malignant disease and only 4/31 in the untransfused group. This difference was highly significant (P less than 0.001, chi-squared test) and using a multivariate analysis the only variable associated with a decreased survival time was whether a blood transfusion had been received. We conclude that peri-operative blood transfusion is associated with decreased survival after laryngectomy. However, whether this association is causal remains unproven.