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Kidney Cancer Patients Fare Worse if They Require Transfusions During Surgery: Presented at AUA
By Ed Susman
ATLANTA, G.A. -- May 25, 2006 -- Patients who require multiple transfusions during cancer surgery for kidney cancer have worse long-term survivals than do patients who undergo operations without need of blood, researchers said here at the Annual Meeting of the American Urological Association (AUA).
"We can only say that there is an association between deaths from kidney cancer and the fact that these patients received blood transfusions during their cancer surgery," said Jonathan Routh, MD, urologist, Mayo Clinic, Rochester, Minnesota, in a press briefing here on May 21s.
Dr. Routh said that the retrospective nature of his study did not allow him to have information that might have shed light on whether there was a cause and effect relationship between blood transfusions and the higher incidence in recurrent cancer in the patients studied.
He noted that historically, blood transfusions were part of the therapy for kidney transplantation because the transfusions reduced immune system response to the transplanted organ. He speculated that in kidney cancer patients it was possible that the immunomodulatory effect of the transfusions hindered the immune system in controlling metastatic kidney cancer disease.
In performing the study, Dr. Routh traced outcomes in 2,442 patients treated for renal cell carcinoma from 1970 to 2002. Of those patients 1,504 died, including 814 who died from the cancer itself.
About 36% of the total number of patients received transfusions. Five years after surgery, 83.1% of patients who were not transfused were alive compared to 51.7% of patients who got transfusions.
Patients who received transfusions during the surgery had a 3.39 greater risk of dying within 7 years of the surgery (P <.001). Even when all variables were figured, the patients who got transfusions had a 48% greater risk of dying than other patients, and that was a statistically significant finding as well (P <.001).
Dr. Routh speculated that transfusions could be a surrogate for morbidity during the surgery, including a possibility that doctors had to work longer to excise the cancer because of anatomical problems associated with the size and position of the tumor.
[Presentation title: Cancer-Specific Mortality Is Increased by Erythrocyte Transfusion in Patients Undergoing Surgery for Renal Cell Carcinoma. Abstract 733]
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