Department of Anesthesiology, Mayo Clinic, Rochester, Minnesota; Department of Anaesthesia, National University Hospital, National University Health System, Republic of Singapore.
Transfusion. 2014 Sep;54(9):2175-81. doi: 10.1111/trf.12595. Epub 2014 Mar 24.
Allogeneic blood transfusion induces immunosuppression, and concern has been raised that it may increase propensity for cancer recurrence; however, these effects have not been confirmed. We examined the association of perioperative transfusion of allogeneic blood long-term oncologic outcomes in patients with prostate cancer who underwent prostatectomy.
We reviewed medical records of patients who underwent radical prostatectomy between 1991 and 2005 and received allogeneic nonleukoreduced blood. Each transfused patient was matched to two controls who did not receive blood: matching included age, surgical year, prostate-specific antigen level, pathologic tumor stages, pathologic Gleason scores, and anesthetic type. Primary outcome was systemic tumor progression, with secondary outcomes of prostate cancer death and all-cause mortality. Stratified proportional hazards regression analysis was used to assess differences in outcomes between the transfused and nontransfused group.
A total of 379 prostatectomy patients who were transfused and 758 nontransfused controls were followed for 9.4 and 10.2 years (median), respectively. In a multivariable analysis that took into account the matched study design and adjusted for positive surgical margins and adjuvant therapies, the use of allogeneic blood was not associated with systemic tumor progression (hazard ratio [HR], 0.88; 95% confidence interval [CI], 0.39-1.99; p = 0.76), prostate cancer-specific death (HR, 1.69; 95% CI, 0.44 to 6.48; p = 0.44), or all-cause death (HR, 1.20; 95% CI, 0.87 to 1.67; p = 0.27).
When adjusted for clinicopathologic and procedural variables transfusion of allogeneic blood was not associated with systemic tumor progression and survival outcomes.
异体输血会引起免疫抑制，人们担心它可能会增加癌症复发的倾向；然而，这些影响尚未得到证实。我们研究了接受前列腺切除术的前列腺癌患者围手术期异体输血与长期肿瘤学结果的关系。
我们回顾了 1991 年至 2005 年间接受根治性前列腺切除术且接受异体非去白细胞输血的患者的病历。每位接受输血的患者与两名未输血的患者相匹配：匹配包括年龄、手术年份、前列腺特异性抗原水平、病理肿瘤分期、病理 Gleason 评分和麻醉类型。主要结果是全身肿瘤进展，次要结果是前列腺癌死亡和全因死亡率。分层比例风险回归分析用于评估输血组和未输血组之间结果的差异。
共有 379 名接受前列腺切除术且接受输血的患者和 758 名未接受输血的对照组患者分别随访 9.4 年和 10.2 年（中位数）。在考虑匹配研究设计并调整了阳性手术切缘和辅助治疗的多变量分析中，异体输血的使用与全身肿瘤进展无关（风险比 [HR]，0.88；95%置信区间 [CI]，0.39-1.99；p = 0.76)、前列腺癌特异性死亡（HR，1.69；95% CI，0.44 至 6.48；p = 0.44) 或全因死亡（HR，1.20；95% CI，0.87 至 1.67；p = 0.27）。
在校正临床病理和手术变量后，异体输血与全身肿瘤进展和生存结果无关。
