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J Thorac Cardiovasc Surg 2003;126:755-760
© 2003 The American Association for Thoracic Surgery

General thoracic surgery

The influence of blood transfusion on survival in operated non–small cell lung cancer patients

^a Departments ofDepartment of Thoracic Surgery, Medical University of Gdañsk, Gdañsk, Poland
^b Department of Oncology and Radiotherapy, Medical University of Gdañsk, Gdañsk, Poland
^c Department of Pneumonology, Medical University of Gdansk, Gdansk, Poland

Received for publication October 1, 2002; revisions received November 5, 2002; revisions received November 28, 2002; accepted for publication January 7, 2003.

^* Address for reprints: Witold Rzyman, MD, PhD, Department of Thoracic Surgery, Medical University of Gdansk, 7 Dêbinki St, 80-211 Gdansk, Poland
wrzyman{at}wp.pl

BACKGROUND: It has been postulated that allogeneic transfusions have immunosuppressive effects that can promote tumor growth and metastasis formation. Despite the variety of publications on this controversial topic, the influence of blood transfusion on survival is not yet clearly identified. The impact of autologous blood transfusion on survival has only occasionally been analyzed in cancer patients.

OBJECTIVE: To determine the effect of perioperative allogeneic and autologous blood transfusions on survival in non–small cell lung cancer patients treated with curative pulmonary resection.

METHODS: Of 493 consecutive patients, 185 (37.5%) received allogeneic blood products and 145 (29.4%) received autologous blood products, whereas 163 patients (33.1%) received no blood products. Survival analysis included univariate log-rank test and multivariate Cox regression model.

RESULTS: Three-year survival probabilities in allogeneic, autologous, and nontransfused groups were 40%, 48%, and 61%, respectively, and the estimated 5-year survival probabilities were 34%, 38%, and 48%, respectively. In the univariate analysis there was a reduced survival in allogeneic versus nontransfused group (P < .01). In the multivariate analysis stage (P < .01), initial hemoglobin level (P = .01) and sedimentation rate (P = .03) remained significant factors, whereas the type of blood transfusion (allogeneic versus autologous) was no longer significant. There was no significant impact of transfusion in the multivariate analysis when patients in stage III or patients who underwent pneumonectomy were excluded.

CONCLUSION: Neither allogeneic nor autologous blood transfusion has independent, adverse survival impact in non–small cell lung cancer patients treated with radical pulmonary resection.

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