Intraoperative Blood Loss and Prognosis in Prostate Cancer Patients Undergoing Radical Retropubic Prostatectomy

Abstract

To assess more thoroughly the prognostic significance of perioperative transfusions, we examined a previously ignored factor, namely intraoperative blood loss. Univariate and multivariate stepwise regression analysis was performed on results of a 10-year series of 251 consecutive men who underwent radical retropubic prostatectomy for clinically localized carcinoma. Gleason score, operative blood loss and pathological stage were significantly (p less than 0.0001) associated with progression-free survival. A risk ratio of 1.08 (95 percent confidence interval 1.05 to 1.10) was demonstrated for every 100 ml. of operative blood loss. The operative blood loss but not the type (autologous or allogeneic) of blood transfused was significantly related to decreased recurrence-free survival after radical retropubic prostatectomy. This finding implies that the operative events necessitating transfusion are potentially more significant than the immunological effects of the transfusion.