1. ¹Intensive Care Unit, University Hospital Aintree, Liverpool L9 1AL, UK
2. ²Regional Maxillofacial Unit University Hospital Aintree, Fazakerley, Liverpool L9 1AL, UK
3. ³Medical Statistician, Regional Maxillofacial Unit University Hospital Aintree, Fazakerley, Liverpool L9 1AL, UK

Correspondence: Dr SN Rogers, E-mail: snrogers@doctors.org.uk

Received 18 October 2005; Revised 23 January 2006; Accepted 30 January 2006.

Abstract

The influence of perioperative blood transfusion in oral and oropharyngeal squamous cell carcinoma remains uncertain. It is believed that blood transfusion downregulates the immune system and may have an influence on cancer recurrence and survival. In all, 559 consecutive patients undergoing primary surgery for oral and oropharyngeal squamous cell carcinoma between 1992 and 2002 were included in this study. Known prognostic variables along with transfusion details were obtained from head and neck cancer and blood transfusion service databases, respectively. Adjusting for relevant prognostic factors in Cox regression, the hazard ratio for patients having 3 or more transfused units relative to those not transfused was 1.52 (95% confidence interval (CI) 0.93–2.47) for disease-specific and 1.52 (95% CI 1.05–2.22) for overall mortality. Blood transfusion of 3 or more units might confer a worse prognosis in patients undergoing primary surgery for oral and oropharyngeal squamous cell carcinoma. Therefore, every effort should be made to limit the amount of blood transfused to the minimum requirement.