title: No impact of blood transfusion on oncological outcome after radical prostatectomy in patients with prostate cancer.
abstract: OBJECTIVE
  To assess the association between blood loss, blood transfusion (BT) and biochemical recurrence (BCR)-free, metastasis-free and overall survival after radical prostatectomy (RP) in a large single-center cohort of patients. Perioperative BT at oncologic surgery has been reported to be a potential risk factor for cancer recurrence and survival in several cancer entities. Current studies addressing the relationship between BT, blood loss and BCR-free survival in prostate cancer patients are controversial and include only series with fairly small patient cohorts.
  
  
  METHODS
  The data of 11,723 patients who underwent RP between 01/1992 and 08/2011 were analyzed. Cox regression analysis, including preoperative PSA level, pT stage, lymph node status, Gleason score, margin status, blood loss, transfusion rate (allogeneic or autologous), tested the relationship between blood loss, transfusion and BCR-free, metastasis-free and overall survival. Additionally, propensity score-matching analysis was performed to adjust differences in tumor characteristics.
  
  
  RESULTS
  There was no statistically significant relationship between blood loss or BT and BCR-free, metastasis-free or overall survival. In multivariate analysis PSA level, pT stage, Gleason score, margin status and lymph node status were independent factors for a BCR (p < 0.0001). These results were identical after propensity score matching analysis, comparing patients with and without BT.
  
  
  CONCLUSIONS
  This large-scale analysis revealed no correlation between blood loss, blood transfusion and oncological outcome in prostate cancer patients treated with RP. Therefore, the association between higher blood loss or transfusion rate and cancer recurrence as described in other surgical treated tumor entities seems to be irrelevant in prostate cancer patients.
authors.affiliation: Martini-Clinic, Prostate Cancer Center, Martinistr.52, 20246, Hamburg, Germany, boehm@martini-klinik.de.
authors.forename: K
authors.initials: K
authors.lastname: Boehm
authors.forename: B
authors.initials: B
authors.lastname: Beyer
authors.forename: P
authors.initials: P
authors.lastname: Tennstedt
authors.forename: J
authors.initials: J
authors.lastname: Schiffmann
authors.forename: L
authors.initials: L
authors.lastname: Budaeus
authors.forename: A
authors.initials: A
authors.lastname: Haese
authors.forename: M
authors.initials: M
authors.lastname: Graefen
authors.forename: T
authors.initials: T
authors.lastname: Schlomm
authors.forename: H
authors.initials: H
authors.lastname: Heinzer
authors.forename: G
authors.initials: G
authors.lastname: Salomon
mesh_terms: D000368:Aged; D000740:Anemia / Q000628:therapy*; D016063:Blood Loss, Surgical; D001803:Blood Transfusion; D015331:Cohort Studies; D018572:Disease-Free Survival; D006801:Humans; D007610:Kallikreins / Q000097:blood*; D008198:Lymph Nodes / Q000473:pathology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D060787:Neoplasm Grading; D009364:Neoplasm Recurrence, Local / Q000097:blood*; D009367:Neoplasm Staging; D009929:Organ Size; D011183:Postoperative Complications / Q000628:therapy*; D016016:Proportional Hazards Models; D011467:Prostate / Q000473:pathology*; D017430:Prostate-Specific Antigen / Q000097:blood*; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: C549870:KLK3 protein, human; D007610:Kallikreins; D017430:Prostate-Specific Antigen