Survival advantage of using autologous blood transfusion during surgery for esophageal cancer.
OBJECTIVE
There is evidence that blood transfusion is associated with an increased rate of tumor recurrence. This study was conducted to assess the survival advantage of giving autologous blood instead of allogeneic blood during surgery for esophageal cancer.


METHODS
We retrospectively analyzed 62 patients who underwent esophagectomy for thoracic esophageal cancer between January 1991 and February 1995 and received allogeneic blood transfusion, and 61 patients operated on between March 1995 and February 1998, who received autologous blood transfusion. The clinicopathological factors and survival rates were compared between the two groups.


RESULTS
The clinicopathological factors that influenced prognosis were similar in the two groups; however, a definite survival advantage was evident in the autologous blood transfusion group. According to multivariate analyses, the transfusion of allogeneic blood was an independent prognostic factor ( P = 0.0222), as was the presence of metastatic lymph nodes. Patients who received allogeneic blood transfusions perioperatively had more than a twofold greater risk (Hazard ration 2.406) of death over patients who received autologous blood transfusions.


CONCLUSIONS
Autologous blood transfusion appears to be an independent prognostic factor for the survival of patients with esophageal cancer.
Motoyama
Satoru
S
Second Department of Surgery, Akita University School of Medicine, Japan.
Saito
Reijiro
R
Kamata
Shuichi
S
Kitamura
Michihiko
M
Okuyama
Manabu
M
Imano
Hiroshi
H
Nakamura
Masakatsu
M
Suzuki
Hiroyuki
H
Omokawa
Susumu
S
Motohashi
Yutaka
Y
Ogawa
Jun-Ichi
J
D000328:Adult; D000368:Aged; D001804:Blood Transfusion, Autologous / Q000009:adverse effects; D004938:Esophageal Neoplasms / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local / Q000209:etiology; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate; D065227:Transfusion Reaction; D016896:Treatment Outcome