Correlation between perioperative blood transfusion and prognosis of patients subjected to surgery for stage I lung cancer.
BACKGROUND
It has been reported, but not proven, that perioperative blood transfusions have a detrimental effect on the survival of patients undergoing surgery for lung cancer.


METHODS
and methods: A prospective study was carried out on the patients undergoing lobectomy for stage I lung cancer at our department from 1995 to 2000. The criteria for exclusion included previous cases of malignancy, autoimmune diseases, and any other relevant comorbidity.


RESULTS
Two hundred eighty-one patients were observed, 24.6% of whom received transfusions. The only significant difference between the transfused and nontransfused patients was their preoperative hemoglobin (Hb) concentration (12.5 +/- 1.20 g/dL vs 13.3 +/- 1.22 g/dL, p < 0.001). The disease-free interval of the transfused patients was significantly lower than that of the nontransfused patients (53% vs 78% at 73 months, p < 0.005), as was also the case for actuarial survival (52% vs 71% at 73 months, p < 0.02). Blood transfusion was significantly predictive of tumor relapse according to the Cox model adjusted for the T state, preoperative Hb concentration, sex, age, histologic type, and grading (hazard ratio, 2.3; p = 0.017).


CONCLUSIONS
Our data show that perioperative blood transfusion is significantly correlated to worse prognosis in patients undergoing surgery for stage I lung cancer.
Nosotti
Mario
M
Thoracic Surgery Unit, I.R.C.C.S. Ospedale Maggiore Policlinico, Milan, Italy. marionosotti@libero.it
Rebulla
Paolo
P
Riccardi
Donatella
D
Baisi
Alessandro
A
Bellaviti
Nadia
N
Rosso
Lorenzo
L
Santambrogio
Luigi
L
D000368:Aged; D001803:Blood Transfusion; D002289:Carcinoma, Non-Small-Cell Lung / Q000401:mortality / Q000601:surgery*; D016022:Case-Control Studies; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011013:Pneumonectomy; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D013997:Time Factors; D065227:Transfusion Reaction