Intraoperative cell salvage during radical cystectomy does not affect long-term survival.
OBJECTIVE
To evaluate the risk of long-term recurrence for patients who received cell-salvaged blood during radical cystectomy (RC).


METHODS
We retrospectively analyzed an RC database and compared those who did and did not receive cell-salvaged blood according to baseline parameters, pathologic outcomes, and recurrence.


RESULTS
A total of 378 patients underwent RC between 1992 and 2005 by one surgeon. Of these, 65 (17.2%) received cell-salvaged blood and 313 (82.8%) did not. The two groups had similar baseline characteristics. There were no differences between the two groups when compared by pathologic stage. The median follow-up for patients who did and did not receive cell-salvaged blood was 19.1 and 20.7 months, respectively (P = 0.464). The 3-year disease-specific survival rate for the two groups was 72.2% and 73.0%, respectively (P = 0.90).


CONCLUSIONS
Intraoperative cell salvage is a safe blood management strategy for patients undergoing RC. There is no increased risk of metastatic disease or death for those who receive cell-salvaged blood. Concerns about spreading tumors cells by IOCS during RC would seem unwarranted. However, only a prospective, multicenter, randomized trial would provide the most valid assessment of the safety of IOCS.
Nieder
Alan M
AM
Department of Urology, University of Miami Miller School of Medicine, Miami, Florida 33140, USA. anieder1@med.miami.edu
Manoharan
Murugesan
M
Yang
Yulong
Y
Soloway
Mark S
MS
D000368:Aged; D016063:Blood Loss, Surgical / Q000517:prevention & control; D001804:Blood Transfusion, Autologous / Q000379:methods*; D002295:Carcinoma, Transitional Cell / Q000401:mortality* / Q000473:pathology / Q000628:therapy*; D015653:Cystectomy / Q000379:methods*; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007430:Intraoperative Care / Q000379:methods; D008297:Male; D008875:Middle Aged; D011336:Probability; D012016:Reference Values; D012189:Retrospective Studies; D018570:Risk Assessment; D016879:Salvage Therapy; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome; D001749:Urinary Bladder Neoplasms / Q000401:mortality* / Q000473:pathology / Q000628:therapy*