title: Lack of effect of perioperative blood transfusion during radical hysterectomy with lymph node dissection on the prognosis of cervical cancer stage Ib.
abstract: The aim of this retrospective study was to analyze the effects of perioperative blood transfusion during radical hysterectomy with lymph node dissection on the prognosis of cervical cancer stage Ib. A total of 295 patients who had undergone surgery from 1987-2002 were included. Forty seven patients underwent conization before definite surgery, and 2 patients were subsequently lost to follow up. Among the remaining 246 patients, 97 received allogenic blood transfusion, 38 received autologous blood transfusion, and 111 received no transfusion. The clinicopathologic finding of these three groups were reviewed and analyzed. There was no significant difference among three groups in age, chief complaints, duration of symptoms, size of lesion, histopathology, grade, margin or parametrium involvement, node status or postoperative adjuvant treatment. The most prominent presenting symptoms were abnormal vaginal discharge, abnormal vaginal bleeding, and postcoital bleeding. Although the 5-year disease-free survival (DFS) (and 95% CI) for autologous blood transfused group was 90.9% (74.4-97.0%), falling to 88.1% (77.8-93.8%) in untransfused blood group and 81.7% (71.3-88.6%) in allogenic transfused blood group, there were no significant differences among three groups (P = 0.699). In multivariate analyses, only age (P = 0.046), size of lesion (P = 0.024) and histology (P = 0.046) were statistically significantly associated with DFS, whereas transfusion status was not. In conclusion, there is no evidence that perioperative blood transfusion affects DFS of patients undergoing radical hysterectomy and pelvic lymphadenectomy. Only age, size of lesion and histology were statistically significantly associated with DFS.
authors.affiliation: Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Faculty of Medicine, Prince of Songkla University, Songkhla 90110, Thailand. hjitti@medicine.psu.ac.th
authors.forename: Jitti
authors.initials: J
authors.lastname: Hanprasertpong
authors.forename: Saibua
authors.initials: S
authors.lastname: Chichareon
authors.forename: Virach
authors.initials: V
authors.lastname: Wootipoom
authors.forename: Rakchai
authors.initials: R
authors.lastname: Buhachat
authors.forename: Sathana
authors.initials: S
authors.lastname: Tassee
authors.forename: Alan
authors.initials: A
authors.lastname: Geater
mesh_terms: D000230:Adenocarcinoma / Q000556:secondary / Q000628:therapy; D000328:Adult; D001803:Blood Transfusion; D018196:Carcinoma, Adenosquamous / Q000556:secondary / Q000628:therapy; D018288:Carcinoma, Small Cell / Q000556:secondary / Q000628:therapy; D002294:Carcinoma, Squamous Cell / Q000556:secondary / Q000628:therapy; D005260:Female; D006801:Humans; D007044:Hysterectomy; D008197:Lymph Node Excision; D008198:Lymph Nodes; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009367:Neoplasm Staging; D019990:Perioperative Care; D011379:Prognosis; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000473:pathology* / Q000628:therapy