INTRAOPERATIVE BLOOD-LOSS AND PROGNOSIS IN PROSTATE-CANCER PATIENTS UNDERGOING RADICAL RETROPUBIC PROSTATECTOMY

Purpose: To assess more thoroughly the prognostic significance of peri operative transfusions, we examined a previously ignored factor, namel y intraoperative blood loss. Materials and Methods: Univariate and mul tivariate stepwise regression analysis was performed on results of a 1 0-year series of 251 consecutive men who underwent radical retropubic prostatectomy for clinically localized carcinoma, Results: Gleason sco re, operative blood loss and pathological stage were significantly (p< 0.0001) associated with progression-free survival. A risk ratio of 1.0 8 (95% confidence interval 1.05 to 1.10) was demonstrated for every 10 0 mi. of operative blood loss. Conclusions: The operative blood loss b ut not the type tautologous or allogeneic) of blood transfused was sig nificantly related to decreased recurrence-free survival after radical retropubic prostatectomy. This finding implies that the operative eve nts necessitating transfusion are potentially more significant than th e immunological effects of the transfusion.