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Erschienen in: World Journal of Urology 3/2012

01.06.2012 | Original Article

Oncologic outcomes following radical prostatectomy with intraoperative cell salvage

verfasst von: Michael A. Gorin, Ahmed Eldefrawy, Murugesan Manoharan, Mark S. Soloway

Erschienen in: World Journal of Urology | Ausgabe 3/2012

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Abstract

Purpose

To evaluate oncologic outcomes following the use of intraoperative cell salvage (IOCS) as a blood loss management strategy during open radical prostatectomy (RP).

Methods

We retrospectively reviewed all open retropubic RP cases performed by a single surgeon. Patients were identified who received IOCS blood and evaluated for an increased risk of biochemical recurrence (BCR) and overall mortality.

Results

The study cohort consisted of 1,862 men, 395 (21.2%) of whom received IOCS blood. At a median follow-up of 47.0 months, men who received IOCS blood were not at an increased risk of BCR (P = 0.323) or all-cause mortality (P = 0.892). IOCS use did not confer an increased risk of BCR within any D’Amico preoperative risk category (low risk, P = 0.592; intermediate risk, P = 0.107; and high risk, P = 0.697).

Conclusions

IOCS is safe for the management of blood loss during RP. At long-term follow-up, IOCS use was not associated with an increased risk of BCR or death. While it remains preferable to avoid any form of blood transfusion, we advocate for the use of IOCS in place of allogeneic blood. These conclusions are drawn from our study of the largest and longest followed cohort patients who received IOCS blood during RP.
Literatur
1.
Zurück zum Zitat Jemal A, Siegel R, Xu J, Ward E (2010) Cancer statistics, 2010. CA Cancer J Clin 60:277–300PubMedCrossRef Jemal A, Siegel R, Xu J, Ward E (2010) Cancer statistics, 2010. CA Cancer J Clin 60:277–300PubMedCrossRef
2.
Zurück zum Zitat Cooperberg MR, Broering JM, Kantoff PW, Carroll PR (2007) Contemporary trends in low risk prostate cancer: risk assessment and treatment. J Urol 178:S14–S19PubMedCrossRef Cooperberg MR, Broering JM, Kantoff PW, Carroll PR (2007) Contemporary trends in low risk prostate cancer: risk assessment and treatment. J Urol 178:S14–S19PubMedCrossRef
3.
Zurück zum Zitat Rabbani F, Yunis LH, Pinochet R, Nogueira L, Vora KC, Eastham JA et al (2010) Comprehensive standardized report of complications of retropubic and laparoscopic radical prostatectomy. Eur Urol 57:371–386PubMedCrossRef Rabbani F, Yunis LH, Pinochet R, Nogueira L, Vora KC, Eastham JA et al (2010) Comprehensive standardized report of complications of retropubic and laparoscopic radical prostatectomy. Eur Urol 57:371–386PubMedCrossRef
4.
Zurück zum Zitat Hu JC, Gu X, Lipsitz SR, Barry MJ, D’Amico AV, Weinberg AC et al (2009) Comparative effectiveness of minimally invasive versus open radical prostatectomy. JAMA 302:1557–1564PubMedCrossRef Hu JC, Gu X, Lipsitz SR, Barry MJ, D’Amico AV, Weinberg AC et al (2009) Comparative effectiveness of minimally invasive versus open radical prostatectomy. JAMA 302:1557–1564PubMedCrossRef
5.
Zurück zum Zitat Di Pierro GB, Baumeister P, Stucki P, Beatrice J, Danuser H, Mattei A (2011) A prospective trial comparing consecutive series of open retropubic and robot-assisted laparoscopic radical prostatectomy in a centre with a limited caseload. Eur Urol 59:1–6PubMedCrossRef Di Pierro GB, Baumeister P, Stucki P, Beatrice J, Danuser H, Mattei A (2011) A prospective trial comparing consecutive series of open retropubic and robot-assisted laparoscopic radical prostatectomy in a centre with a limited caseload. Eur Urol 59:1–6PubMedCrossRef
6.
Zurück zum Zitat Noldus J, Gonnermann D, Huland H (1995) Autologous blood transfusion in radical prostatectomy: results in 263 patients. Eur Urol 27:213–217PubMed Noldus J, Gonnermann D, Huland H (1995) Autologous blood transfusion in radical prostatectomy: results in 263 patients. Eur Urol 27:213–217PubMed
7.
Zurück zum Zitat Lepor H, Lipkin M, Slova D (2010) The preoperative use of erythropoietin stimulating proteins prior to radical prostatectomy is not associated with increased cardiovascular or thromboembolic morbidity or mortality. Urology 75:1424–1428PubMedCrossRef Lepor H, Lipkin M, Slova D (2010) The preoperative use of erythropoietin stimulating proteins prior to radical prostatectomy is not associated with increased cardiovascular or thromboembolic morbidity or mortality. Urology 75:1424–1428PubMedCrossRef
8.
Zurück zum Zitat Takayanagi A, Masumori N, Kobayashi K, Kunishima Y, Takahashi A, Itoh N et al (2008) Acute normovolemic hemodilution for radical retropubic prostatectomy and radical cystectomy. Urology 72:401–405PubMedCrossRef Takayanagi A, Masumori N, Kobayashi K, Kunishima Y, Takahashi A, Itoh N et al (2008) Acute normovolemic hemodilution for radical retropubic prostatectomy and radical cystectomy. Urology 72:401–405PubMedCrossRef
9.
Zurück zum Zitat Gray CL, Amling CL, Polston GR, Powell CR, Kane CJ (2001) Intraoperative cell salvage in radical retropubic prostatectomy. Urology 58:740–745PubMedCrossRef Gray CL, Amling CL, Polston GR, Powell CR, Kane CJ (2001) Intraoperative cell salvage in radical retropubic prostatectomy. Urology 58:740–745PubMedCrossRef
10.
Zurück zum Zitat Vamvakas EC, Blajchman MA (2009) Transfusion-related mortality: the ongoing risks of allogeneic blood transfusion and the available strategies for their prevention. Blood 113:3406–3417PubMedCrossRef Vamvakas EC, Blajchman MA (2009) Transfusion-related mortality: the ongoing risks of allogeneic blood transfusion and the available strategies for their prevention. Blood 113:3406–3417PubMedCrossRef
11.
Zurück zum Zitat Davis M, Sofer M, Gomez-Marin O, Bruck D, Soloway MS (2003) The use of cell salvage during radical retropubic prostatectomy: does it influence cancer recurrence? BJU Int 91:474–476PubMedCrossRef Davis M, Sofer M, Gomez-Marin O, Bruck D, Soloway MS (2003) The use of cell salvage during radical retropubic prostatectomy: does it influence cancer recurrence? BJU Int 91:474–476PubMedCrossRef
12.
Zurück zum Zitat Nieder AM, Carmack AJ, Sved PD, Kim SS, Manoharan M, Soloway MS (2005) Intraoperative cell salvage during radical prostatectomy is not associated with greater biochemical recurrence rate. Urology 65:730–734PubMedCrossRef Nieder AM, Carmack AJ, Sved PD, Kim SS, Manoharan M, Soloway MS (2005) Intraoperative cell salvage during radical prostatectomy is not associated with greater biochemical recurrence rate. Urology 65:730–734PubMedCrossRef
13.
Zurück zum Zitat Cookson MS, Aus G, Burnett AL, Canby-Hagino ED, D’Amico AV, Dmochowski RR et al (2007) Variation in the definition of biochemical recurrence in patients treated for localized prostate cancer: the American Urological Association Prostate Guidelines for localized prostate cancer update panel report and recommendations for a standard in the reporting of surgical outcomes. J Urol 177:540–545PubMedCrossRef Cookson MS, Aus G, Burnett AL, Canby-Hagino ED, D’Amico AV, Dmochowski RR et al (2007) Variation in the definition of biochemical recurrence in patients treated for localized prostate cancer: the American Urological Association Prostate Guidelines for localized prostate cancer update panel report and recommendations for a standard in the reporting of surgical outcomes. J Urol 177:540–545PubMedCrossRef
14.
Zurück zum Zitat D’Amico AV, Whittington R, Malkowicz SB, Schultz D, Blank K, Broderick GA et al (1998) Biochemical outcome after radical prostatectomy, external beam radiation therapy, or interstitial radiation therapy for clinically localized prostate cancer. JAMA 280:969–974PubMedCrossRef D’Amico AV, Whittington R, Malkowicz SB, Schultz D, Blank K, Broderick GA et al (1998) Biochemical outcome after radical prostatectomy, external beam radiation therapy, or interstitial radiation therapy for clinically localized prostate cancer. JAMA 280:969–974PubMedCrossRef
16.
Zurück zum Zitat Ward JF, Nowacki M, Sands JP, Conner RJ, Huisman TK (1996) Malignant cytological washings from radical prostatectomy specimens: a possible mechanism for local recurrence of prostate cancer following surgical treatment of organ confined disease. J Urol 156:1381–1384PubMedCrossRef Ward JF, Nowacki M, Sands JP, Conner RJ, Huisman TK (1996) Malignant cytological washings from radical prostatectomy specimens: a possible mechanism for local recurrence of prostate cancer following surgical treatment of organ confined disease. J Urol 156:1381–1384PubMedCrossRef
17.
Zurück zum Zitat Ward JF, Sands JP, Nowacki M, Amling CL (2001) Malignant cytological washings from prostate specimens: an independent predictor of biochemical progression after radical prostatectomy. J Urol 165:469–473PubMedCrossRef Ward JF, Sands JP, Nowacki M, Amling CL (2001) Malignant cytological washings from prostate specimens: an independent predictor of biochemical progression after radical prostatectomy. J Urol 165:469–473PubMedCrossRef
18.
Zurück zum Zitat Nieder AM, Manoharan M, Yang Y, Soloway MS (2007) Intraoperative cell salvage during radical cystectomy does not affect long-term survival. Urology 69:881–884PubMedCrossRef Nieder AM, Manoharan M, Yang Y, Soloway MS (2007) Intraoperative cell salvage during radical cystectomy does not affect long-term survival. Urology 69:881–884PubMedCrossRef
19.
Zurück zum Zitat MacIvor D, Nelson J, Triulzi D (2009) Impact of intraoperative red blood cell salvage on transfusion requirements and outcomes in radical prostatectomy. Transfusion 49:1431–1434PubMedCrossRef MacIvor D, Nelson J, Triulzi D (2009) Impact of intraoperative red blood cell salvage on transfusion requirements and outcomes in radical prostatectomy. Transfusion 49:1431–1434PubMedCrossRef
20.
Zurück zum Zitat Valbonesi M, Bruni R, Lercari G, Florio G, Carlier P, Morelli F (1999) Autoapheresis and intraoperative blood salvage in oncologic surgery. Transfus Sci 21:129–139PubMedCrossRef Valbonesi M, Bruni R, Lercari G, Florio G, Carlier P, Morelli F (1999) Autoapheresis and intraoperative blood salvage in oncologic surgery. Transfus Sci 21:129–139PubMedCrossRef
21.
Zurück zum Zitat Hansen E, Bechmann V, Altmeppen J (2002) Intraoperative blood salvage in cancer surgery: safe and effective? Transfus Apher Sci 27:153–157PubMedCrossRef Hansen E, Bechmann V, Altmeppen J (2002) Intraoperative blood salvage in cancer surgery: safe and effective? Transfus Apher Sci 27:153–157PubMedCrossRef
Metadaten
Titel
Oncologic outcomes following radical prostatectomy with intraoperative cell salvage
verfasst von
Michael A. Gorin
Ahmed Eldefrawy
Murugesan Manoharan
Mark S. Soloway
Publikationsdatum
01.06.2012
Verlag
Springer-Verlag
Erschienen in
World Journal of Urology / Ausgabe 3/2012
Print ISSN: 0724-4983
Elektronische ISSN: 1433-8726
DOI
https://doi.org/10.1007/s00345-011-0746-4

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