Recent reports have suggested that perioperative blood transfusions may adversely affect prognosis after resection of non-small cell lung cancer (NSCLC). To determine the impact of perioperative transfusion on the recurrence-free interval, the status of 352 patients who underwent pulmonary resection for pathologic Stages I and I1 NSCLC was investigated. Transfused patients were significantly older than untransfused patients (P = 0.0009) but were not significantly different in sex distribution (P = 0.12) or tumor stage (P = 0.09). Recurrence was not significantly different in transfused patients when compared with patients who received no blood (P = 0.23) even when stratified for stage (Stage I, P = 0.58; Stage 11, P = 0.14). Furthermore, the number of units transfused was not associated with time to tumor recurrence (P = 0.58). Contrary to other reports, these results do not support the contention that perioperative blood transfusion is significantly associated with decreased recurrence-free survival.
Cancer 62:606-610,1988.
AJOR DETERMINANTS of patient survival after M complete resection of lung cancer are tumor size and nodal Pathologic staging by the tumor-node-metastasis (TNM) system has proved successful in classifying patients according to their risk for tumor recurrence. Other prognostic factors such as histology, leukocyte count, and carcinoembryonic antigen (CEA) level have been suggested3 but are not universally accepted as predictive of recurrence. Recently, perioperative blood transfusion has been proposed as an additional modulator of lung-tumor Blood transfusion is known to have a beneficial effect on renal transplantati~n.~.' Although the mechanism of increased graft survival has not yet been fully elucidated, in vivo and in vitro measurements support the contention that allogeneic blood transfusion results in immu-nosuppre~sion.*-~~ In order to explore further the clinical implications of blood transfusion, we undertook a retrospective study to assess the association of perioperative blood transfusion with non-small cell lung cancer (NSCLC) recurrence.