Intraoperative autologous blood transfusion use during radical hysterectomy for cervical cancer: long-term follow-up of a prospective trial

Abstract

A primary operative complication of radical hysterectomy for cervical cancer is hemorrhage. Intraoperative autologous blood transfusion (ABT) may be beneficial in reducing the need for homologous blood transfusion. Our institution published a prospective cohort study examining the use of ABT in cervical cancer patients undergoing radical hysterectomy in 1995. Patients who were initially consented to participate in this prospective trial using intraoperative ABT (cell saver) were evaluated with a median follow-up of 3years. We sought to update this original report with 16-year follow-up data collected from the clinical charts, Tumor Registry, and the Social Security Death Index. Two groups of patients undergoing radical hysterectomy were compared: patients who received ABT, and those who did not. Of the 71 original patients, all were included in this updated review, with an average follow-up of 12.4years for both groups. Originally, thirty-one patients received an ABT. In this group, 1 patient was lost to follow-up, and 4 (12.9%) are deceased including 1 (3%) with disease. In the non-autologous group, there were 7 (17.5%) patient deaths, including 3 (7.5%) with disease. Eighty-three percent were alive after 12years in both groups. The ABT group had 1 patient (3%) who developed a secondary malignancy, a colon adenocarcinoma. The non-autologous group had 2 patients (5%) who developed a secondary malignancy; one patient developed multiple myeloma and one patient developed a verrucous cancer of the tongue. Autologous blood transfusion during radical hysterectomy for cervical cancer appears safe and effective.