Blood Transfusion and the Risk of Recurrence in Squamous Cell Carcinoma of the Cervix

Abstract

The objective of this study was to determine whether perioperative blood transfusion adversely affected risk of recurrence in 504 evaluable patients with stage I squamous cell carcinoma of the cervix accessioned prospectively in a Gynecologic Oncology Group study. After eliminating patients with advanced-stage disease, wrong cell type, and those without transfusion information available, 504 of 1,125 patients accrued to Gynecologic Oncology Group Protocol 49 were included in this study. Seventy-seven percent of the patients received blood products within 2 weeks of surgery. Either the Pearson chi-square or Fisher exact test assesses the association of categorical clinical–pathologic factors with respect to transfusion status. Cox’s proportional hazards model was used to identify and simultaneously evaluate the independent prognostic factors associated with survival and recurrence-free interval (RFI). The number of units transfused was found to be significantly related to RFI and survival using univariate analysis. When adjusted for clinical tumor size, capillary–lymphatic space involvement, and depth of tumor invasion using multivariate analysis, the number of units transfused was no longer statistically significant with respect to either RFI or survival. Recurrence and survival in patients with squamous cell cancer of the cervix could not be shown to be independently related to transfusion status.