DOES PERIOPERATIVE BLOOD-TRANSFUSION AFFECT SURVIVAL IN PATIENTS WITHCERVICAL-CANCER TREATED WITH RADICAL HYSTERECTOMY

Objective: To determine if blood transfusions during or after radical hysterectomy adversely affect survival in patients with invasive cervi cal carcinoma. Methods: Two hundred eighty-three women with stage IA2- IIA cervical cancer were treated with radical hysterectomy and pelvic lymphadenectomy from 1980-1989. Thirteen were lost to follow-up, and f ive others received adjuvant chemotherapy. Among the remaining 265 pat ients, 131 were given blood transfusions during surgery or within 30 d ays, whereas 134 were not. The clinical and pathologic characteristics of these two groups were reviewed and analyzed statistically. Results : Transfused and nontransfused patients did not differ with respect to mean age (45.0 versus 43.4 years, respectively), stage, grade, cell t ype, depth of invasion, or prevalence of nodal metastasis. Transfused patients more frequently received adjuvant pelvic irradiation than did nontransfused (47 versus 33%, respectively, chi(2) P < .05). After a mean follow-up of 51 months (range 13-125), 19 women (14%) in each gro up were diagnosed as having recurrent disease, predominantly in the pe lvis. Using life-table analysis, the calculated B-year survival was 86 % for transfused and 84% for nontransfused patients, a nonsignificant difference. Disease-free survival was also similar. In the study popul ation, grade, depth of invasion, and nodal status predicted survival. When patients were stratified according to age, cell type, stage, dept h of invasion, nodal involvement, and use of adjuvant radiation, blood transfusion still did not adversely influence survival. Using the Cox proportional hazards model, only nodal status was an independent pred ictor of death. Conclusion: Perioperative blood transfusion does not i mpact overall survival or time to recurrence after radical hysterectom y.