Perioperative transfusion, postoperative infection, and recurrence of head and neck cancer.

BACKGROUND

Immunologic effects of perioperative transfusion and postoperative infection have been purported to influence cancer recurrence rates.

METHODS

Records of all head and neck cancer patients having surgical extirpation of the primary tumor and/or regional nodes at our institution over a 5-year period were reviewed. Time to recurrence was the outcome measure. All variables were evaluated via univariate analysis using log rank tests, with Cox proportional hazards used for multivariate analyses.

RESULTS

Univariate analysis identified the following as potential prognostic factors associated with recurrence: nodal stage, total lymphocyte count, overall stage, amount transfused, occurrence of a transfusion, and the American Society of Anesthesiologists status. Various backward stepwise multivariate regression models showed that neither transfusion nor postoperative infection independently influenced recurrence. However, transfusion of 3 or more units did surface as an independent contributor to recurrence, and in certain subgroups there was a trend toward improved survival for those who had a postoperative infection.

CONCLUSIONS

In this series, neither perioperative transfusion nor postoperative infection independently influenced recurrence.