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 duringradical hysterectomy with lymph node dissection on the prognosis of cervical cancer stage Ib. A total of 295patients who had undergone surgery from 1987-2002 were included. Forty seven patients underwent conizationbefore 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 significantdifference 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 mostprominent presenting symptoms were abnormal vaginal discharge, abnormal vaginal bleeding, and postcoitalbleeding. Although the 5-year disease-free survival (DFS) (and 95% CI) for autologous blood transfused groupwas 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%) inallogenic transfused blood group, there were no significant differences among three groups (P = 0.699). Inmultivariate analyses, only age (P = 0.046), size of lesion (P = 0.024) and histology (P = 0.046) were statisticallysignificantly associated with DFS, whereas transfusion status was not. In conclusion, there is no evidence thatperioperative blood transfusion affects DFS of patients undergoing radical hysterectomy and pelviclymphadenectomy. Only age, size of lesion and histology were statistically significantly associated with DFS.

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