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

Nieder AM, Manoharan M, Yang Y, Soloway MS

Department of Urology, University of Miami Miller School of Medicine, Miami, Florida 33140, USA. anieder1@med.miami.edu

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.

Published 7 May 2007 in Urology, 69(5): 881-4.
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