title: Homologous blood transfusion in patients with prostate cancer: no effect on tumor progression or survival.
abstract: OBJECTIVE
  To determine the effect of perioperative blood transfusions in patients with prostate cancer who underwent radical prostatectomy, we analyzed 1,785 patients with a follow-up of five years or more who were treated during a twenty-one-year period (1966 to 1987).
  
  
  METHODS
  Patients were divided into three groups according to the number of units transfused during the perioperative period: group 1, 0 units (n = 440), group 2, 1 to 2 units (n = 746), and group 3, 3 or more units (n = 599).
  
  
  RESULTS
  With univariate analysis, no statistically significant differences were found among the three groups in overall survival rate (71%, 75%, and 71% at ten years; p = 0.48), cause-specific survival rate (89%, 88%, and 86% at ten years; p = 0.36), or progression-free survival rate (61%, 68%, and 68% at ten years; p = 0.83). Adjusting for tumor grade, pathologic stage, and hormonal therapy using the Cox statistical model, we found no significant association between the blood-use group and overall survival rate (p = 0.45), cause-specific survival rate (p = 0.17), or progression-free survival rate (p = 0.34). The estimated relative risk and 95 percent confidence interval associated with blood transfusion (three or more units versus none) were as follows: 1.03 and 0.76 to 1.38 for total mortality, 1.56 and 0.95 to 2.56 for cause-specific death, and 1.20 and 0.91 to 1.57 for disease progression, respectively.
  
  
  CONCLUSIONS
  According to these findings, withholding homologous blood transfusion, except for infectious precautions, should not be based on the suspicion that it can accelerate death from cancer in patients who undergo radical prostatectomy for prostate cancer.
authors.affiliation: Department of Urology, Mayo Clinic, Rochester, Minnesota.
authors.forename: S R
authors.initials: SR
authors.lastname: Velagapudi
authors.forename: M
authors.initials: M
authors.lastname: Frydenberg
authors.forename: J E
authors.initials: JE
authors.lastname: Oesterling
authors.forename: E J
authors.initials: EJ
authors.lastname: Bergstralh
authors.forename: S B
authors.initials: SB
authors.lastname: Moore
authors.forename: H C
authors.initials: HC
authors.lastname: Ruckle
authors.forename: H
authors.initials: H
authors.lastname: Zincke
mesh_terms: D000328:Adult; D000368:Aged; D001804:Blood Transfusion, Autologous; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000401:mortality* / Q000473:pathology* / Q000601:surgery; D012189:Retrospective Studies; D015996:Survival Rate