Autologous and heterologous blood transfusion in head and neck cancer surgery

Objective: To determine if the use of autologous blood ameliorates the incr eased risk for cancer recurrence that has been associated with perioperativ e blood transfusion. Design: Retrospective medical record review. Setting: Tertiary care hospital. Patients: One hundred sixty-five consecutive patients with stages II to IV squamous cell carcinoma of the head and neck treated surgically at a univer sity hospital from January 1, 1989, through December 31, 1994. Main Outcome Measures: We evaluated the impact of perioperative autologous and heterologous blood transfusion and 10 other variables on recurrence. Un ivariate and multivariate analyses were used. Results: Heterologous blood recipients had a 59% recurrence rate, whereas t hose who had received autologous blood or no transfusion had recurrence rat es of 33% and 35%, respectively. The following 4 variables had a statistica lly significant association with recurrence by multivariate analysis: previ ous treatment of current malignancy (P<.001); receipt of heterologous blood (P=.04); positive margin (P=.04); and nodal disease (P=.04). The receipt: of heterologous blood was associated with a 40% increased risk for recurren ce. Conclusion: Autologous blood products should be used during head and neck c ancer surgery if possible when transfusion is necessary.