Intraoperative cell salvage in radical retropubic prostatectomy.

Gray CL, Amling CL, Polston GR, Powell CR, Kane CJ
Urology 2001;58(5):740-745.
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This article attempts a risk evaluation with only 62 patients. Unfortunately, statistics tell us that, even to show a risk increase (e.g., of metastasis) by as much as 10%, one needs more than 1000 patients (Harrison et al., Br J Surg 1992;79:355-357)! In terms of transfusion risks, a level of sensitivity of 10% is out of range. By way of example, who would suggest to abandon testing for HBV and HCV on the grounds that no HBV and HCV cases occurred after the transfusion of 62 patients?

Thus, only the demonstration of an efficient elimination of blood contaminating tumor cells, but not a limited clinical study, could allow us to overcome the contraindication of blood salvage in cancer surgery. Such an elimination rate (12 Log) has been demonstrated for blood irradiation, but not for leukocyte depletion filters (2-4 Log).

– E. Hansen.