BLOOD-TRANSFUSION AND THE RISK OF RECURRENCE IN STAGE IB CERVICAL-CANCER

Citation
Pc. Morris et al., BLOOD-TRANSFUSION AND THE RISK OF RECURRENCE IN STAGE IB CERVICAL-CANCER, Gynecologic oncology, 57(3), 1995, pp. 401-406
Citations number
29
Categorie Soggetti
Oncology,"Obsetric & Gynecology
Journal title
ISSN journal
00908258
Volume
57
Issue
3
Year of publication
1995
Pages
401 - 406
Database
ISI
SICI code
0090-8258(1995)57:3<401:BATROR>2.0.ZU;2-2
Abstract
The objective of this study is to determine if perioperative blood tra nsfusions increase the risk of recurrence in stage IB cervical cancer. Medical records from all patients with FIGO stage IB cervical cancer undergoing radical hysterectomy and pelvic lymphadenectomy (RH + PLND) at the University of Iowa and the University of Nebraska from 1978 to 1990 were retrospectively reviewed. Data collected included patient a ge, body mass index (BMI), tumor size, cell type, depth of cervical in vasion (DOI), presence of capillary-lymphatic space involvement (CLSI) , lymph node metastasis, operating time, estimated blood loss, transfu sion, and follow-up data. Three hundred two patients underwent RH + PL ND. Transfusions were given to 244 (81%), with a mean of 2.6 units (ra nge 1-18 units). Median follow-up was 49.5 months (range 9-190 months) . Twenty patients (6.6%) had pelvic nodal metastasis. There were no pe riaortic nodal metastases in the 101 patients who had periaortic nodes dissected. There were no significant differences between the transfus ed and nontransfused groups, with respect to age, BMI, DOI, or pelvic node metastasis. Transfused patients differed significantly from the n ontransfused in that they had larger tumors (P = 0.047), more frequent CLSI (P = 0.013), longer procedures (P = 0.02), and greater estimated blood loss (P < 0.0001). Recurrences developed in 29 patients (19 pel vic, 7 lung, 3 bone). There is no difference in disease-free survival (DFS) or calculated projected survival between the transfused and nont ransfused groups. Pelvic node metastasis and tumor size were independe nt poor prognosticators. After controlling for these factors, the numb er of blood transfusions was not predictive of recurrence or survival. Perioperative transfusions do not increase the risk of recurrence in patients with cervical cancer. (C) 1995 Academic Press, Inc.