INTRAOPERATIVE BLOOD-LOSS AND PROGNOSIS IN PROSTATE-CANCER PATIENTS UNDERGOING RADICAL RETROPUBIC PROSTATECTOMY

Purpose: To assess more thoroughly the prognostic significance of perioperative transfusions, we examined a previously ignored factor, namely intraoperative blood loss. Materials and Methods: 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, Results: Gleason score, operative blood loss and pathological stage were significantly (p<0.0001) associated with progression-free survival. A risk ratio of 1.08 (95% confidence interval 1.05 to 1.10) was demonstrated for every 100 mi. of operative blood loss. Conclusions: The operative blood loss but not the type tautologous 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.