PERIOPERATIVE TRANSFUSION, POSTOPERATIVE INFECTION, AND RECURRENCE OFHEAD AND NECK-CANCER

Background. Immunologic effects of perioperative transfusion and posto perative infection have been purported to influence cancer recurrence rates. Methods. Records of all head and neck cancer patients having su rgical extirpation of the primary tumor and/or regional nodes at our i nstitution over a 5-year period were reviewed. Time to recurrence was the outcome measure. All variables were evaluated via univariate analy sis using log rank tests, with Cox proportional hazards used for multi variate analyses. Results. Univariate analysis identified the followin g as potential prognostic factors associated with recurrence: nodal st age, total lymphocyte count, overall stage, amount transfused, occurre nce of a transfusion, and the American Society of Anesthesiologists st atus. Various backward stepwise multivariate regression models showed that neither transfusion nor postoperative infection independently inf luenced recurrence. However, transfusion of 3 or more units did surfac e as an independent contributor to recurrence, and in certain subgroup s there was a trend toward improved survival for those who had a posto perative infection. Conclusions. In this series, neither perioperative transfusion nor postoperative infection independently influenced recu rrence.