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Perioperative allogenic blood transfusions and the risk of endometrial cancer recurrence.
MedLine Citation:
PMID:  23229580     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
PURPOSE: To evaluate the effect of perioperative blood transfusions on the risk of recurrence of endometrial cancer. METHODS: This study is a retrospective analysis of 358 consecutive patients, without a history of other tumors, who underwent surgery for endometrial cancer between January 2000 and April 2010. RESULTS: Women who did not need any transfusion (N = 331) and patients who received allogenic blood donations (N = 27) were compared in terms of risk of cancer recurrence. The surgical standard procedure included peritoneal washing for cytologic examination, total hysterectomy + bilateral adnexectomy (N = 358), and pelvic lymphadenectomy (N = 227). The two groups were homogeneous in term of age, BMI, previous abdominal surgery, type of intervention, operative time, nodal count, and hospital stay. The median (range) estimated blood loss was higher in the transfusion group, 400 mL (100-2,000 mL), than in the non-transfusion group, 150 mL (10-1,000 mL). Median (range) follow-up was 67.5 months (6-132.4 months). Blood transfusions were associated with a higher relapse rate (P = 0.0021). At multivariate analysis, administration of packed red blood cells remained independently associated with recurrence (OR 4.64; CI 95 % 1.45-14.9), as well as myometrial invasion ≥50 % (OR 2.88; CI 95 % 1.18-7.07) and stage >1 (OR 4.24; CI 95 % 1.75-10.3). CONCLUSIONS: The use of allogenic blood transfusions is associated with a higher risk of recurrence. We hypothesize that this could be due to a transitory perioperative immunodepression that promotes the spread of neoplastic cells.
Authors:
Stefano Uccella; Fabio Ghezzi; Antonella Cromi; Giorgio Bogani; Giorgio Formenti; Nicoletta Donadello; Maurizio Serati; Pierfrancesco Bolis
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-12-11
Journal Detail:
Title:  Archives of gynecology and obstetrics     Volume:  -     ISSN:  1432-0711     ISO Abbreviation:  Arch. Gynecol. Obstet.     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-12-11     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8710213     Medline TA:  Arch Gynecol Obstet     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Departments of Obstetrics and Gynecology, University of Insubria, Piazza Biroldi, 1, 21100, Varese, Italy, stefucc@libero.it.
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