Intraoperative cell salvage during radical cystectomy does not affect long-term survival

Urology. 2007 May;69(5):881-4. doi: 10.1016/j.urology.2007.01.060.

Abstract

Objectives: To evaluate the risk of long-term recurrence for patients who received cell-salvaged blood during radical cystectomy (RC).

Methods: We retrospectively analyzed an RC database and compared those who did and did not receive cell-salvaged blood according to baseline parameters, pathologic outcomes, and recurrence.

Results: A total of 378 patients underwent RC between 1992 and 2005 by one surgeon. Of these, 65 (17.2%) received cell-salvaged blood and 313 (82.8%) did not. The two groups had similar baseline characteristics. There were no differences between the two groups when compared by pathologic stage. The median follow-up for patients who did and did not receive cell-salvaged blood was 19.1 and 20.7 months, respectively (P = 0.464). The 3-year disease-specific survival rate for the two groups was 72.2% and 73.0%, respectively (P = 0.90).

Conclusions: Intraoperative cell salvage is a safe blood management strategy for patients undergoing RC. There is no increased risk of metastatic disease or death for those who receive cell-salvaged blood. Concerns about spreading tumors cells by IOCS during RC would seem unwarranted. However, only a prospective, multicenter, randomized trial would provide the most valid assessment of the safety of IOCS.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Blood Loss, Surgical / prevention & control
  • Blood Transfusion, Autologous / methods*
  • Carcinoma, Transitional Cell / mortality*
  • Carcinoma, Transitional Cell / pathology
  • Carcinoma, Transitional Cell / therapy*
  • Cystectomy / methods*
  • Disease-Free Survival
  • Female
  • Follow-Up Studies
  • Humans
  • Intraoperative Care / methods
  • Male
  • Middle Aged
  • Probability
  • Reference Values
  • Retrospective Studies
  • Risk Assessment
  • Salvage Therapy
  • Survival Analysis
  • Time Factors
  • Treatment Outcome
  • Urinary Bladder Neoplasms / mortality*
  • Urinary Bladder Neoplasms / pathology
  • Urinary Bladder Neoplasms / therapy*