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Intraoperative blood loss and prognosis in prostate cancer patients undergoing radical retropubic prostatectomy
M G Oefelein1, L A Colangelo, A W Rademaker
1Department of Urology, Northwestern University Medical School, Chicago, Illinois 60611, USA.
Purpose:
To assess more thoroughly the prognostic significance of perioperative transfusions, we examined a previously ignored factor, namely intraoperative blood loss.
Materials And Methods:
Univariate and multivariate stepwise regression analysis was performed on results of a 10-year series of 251 consecutive men who underwent radical retropubic prostatectomy for clinically localized carcinoma.
Results:
Gleason score, operative blood loss and pathological stage were significantly (p < 0.0001) associated with progression-free survival. A risk ratio of 1.08 (95% confidence interval 1.05 to 1.10) was demonstrated for every 100 ml. of operative blood loss.
Conclusions:
The operative blood loss but not the type (autologous or allogeneic) of blood transfused was significantly related to decreased recurrence-free survival after radical retropubic prostatectomy. This finding implies that the operative events necessitating transfusion are potentially more significant than the immunological effects of the transfusion.
