Blood Storage Duration and Biochemical Recurrence of Cancer After Radical Prostatectomy
Blood Storage Duration and Biochemical Recurrence of Cancer After Radical Prostatectomy
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DOI：
10.4065/mcp.2010.0313
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发表时间：
2011-02-01
影响因子：
8.9
通讯作者：
Sessler, Daniel I.
中科院分区：
文献类型：
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作者：
Cata, Juan P.;Klein, Eric A.;Sessler, Daniel I.
目的：验证长期输注异体和自体红细胞(RBC)促进前列腺癌术后生化复发的假说。方法与方法：我们评估了1998年7月6日至2007年12月27日期间接受根治性前列腺切除术和围手术期输血的前列腺癌患者的生化复发情况。那些接受异基因输血的人被分配到不重叠的“年轻”、“中等”和“较老”的RBC保存时间组。对那些接受自体红细胞输注的人进行分析，使用最长储存时间作为主要暴露时间。我们用多变量COX比例风险回归分析了红细胞保存时间和生化复发之间的关系。结果：共有405名患者接受了异基因输血。5年后，接受年轻、中等和老年红细胞移植的患者的无生化复发生存率分别为74%、71%和76%；我们的Cox模型显示两组之间的生化复发率没有显著差异(P=.82；Wald检验)。在接受自体输血的患者中(n=350)，最大红细胞年龄与生化癌症复发没有显著相关性(P=.95)。5年后，接受小于21天和大于21天的红细胞移植的患者的生化无复发生存率分别为85%和81%。结论：在接受根治性前列腺切除术并需要输血的患者中，复发风险似乎与血液储存时间无关。
OBJECTIVE: To test the hypothesis that perioperative transfusion of allogeneic and autologous red blood cells (RBCs) stored for a prolonged period speeds biochemical recurrence of prostate cancer after prostatectomy.PATIENTS AND METHODS: We evaluated biochemical prostate cancer recurrence in men who had undergone radical prostatectomy and perioperative blood transfusions from July 6, 1998, through December 27, 2007. Those who received allogeneic blood transfusions were assigned to nonoverlapping "younger," "middle," and "older" RBC storage duration groups. Those who received autologous RBC transfusions were analyzed using the maximum storage duration as the primary exposure. We evaluated the association between RBC storage duration and biochemical recurrence using multivariable Cox proportional hazards regression.RESULTS: A total of 405 patients received allogeneic transfusions. At 5 years, the biochemical recurrence free survival rate was 74%, 71%, and 76% for patients who received younger, middle, and older RBCs, respectively; our Cox model indicated no significant differences In biochemical recurrence rates between the groups (P=.82; Wald test). Among patients who received autologous transfusions (n=350), maximum RBC age was not significantly associated with biochemical cancer recurrence (P=.95). At 5 years, the biochemical recurrence free survival rate was 85% and 81% for patients who received younger and older than 21-day-old RBCs, respectively.CONCLUSION: In patients undergoing radical prostatectomy who require RBC transfusion, recurrence risk does not appear to be independently associated with blood storage duration.