Skip to main content
Journal cover image

Factors associated with blood loss during radical prostatectomy for localized prostate cancer in the prostate-specific antigen (PSA)-era: an overview of the Department of Defense (DOD) Center for Prostate Disease Research (CPDR) national database.

Publication ,  Journal Article
Moul, JW; Sun, L; Wu, H; McLeod, DG; Amling, C; Lance, R; Foley, J; Sexton, W; Kusuda, L; Chung, A; Soderdahl, D; Donahue, T
Published in: Urol Oncol
2003

Radical Prostatectomy (RP) has been traditionally associated with significant operative blood loss and high risk of transfusion. However, over the last few years, centers of excellence have reported less bleeding and transfusion. To verify and document changes in the epidemiology of bleeding and transfusion of men electing RP, we undertook an analysis of such cases in the Department of Defense (DoD) Center for Prostate Disease Research (CPDR) Multicenter Research Database. Using the Department of Defense Center for Prostate Disease Research (CPDR) Multicenter National Research Database, a query of all RPs performed between January 1, 1985 and December 31, 2000 was conducted revealing 2918 cases with blood-loss data available for analysis from nine hospital sites. These cases were analyzed over time (calendar year) and changes in the characteristics of the patients, disease severity, and surgical results were compared with estimated blood loss (EBL) and transfusion data. Among the 2918 evaluable men, 2399 (82%) underwent a retropubic RP, 97% had clinical T1-2 disease, and 77% had a PSA level > or =10.0 ng/mL. Overall median operation time was 3.8 h, and EBL was 1000 cc. Examining trends over time, there was a dramatic decline in median operative time, EBL, and transfusion rate. In multiple linear regression analysis, operative time, operative approach, surgery year, lymphadenectomy status, and neoadjuvant hormonal therapy were significant predictor of EBL. Blood loss difference between retropubic and perineal RP became insignificant in the latter years. Radical prostatectomy is being performed more commonly on men with earlier stage disease in the PSA-Era. The operation is now performed more rapidly with less blood loss and fewer transfusion requirements. In a broad practice experience represented here, autologous blood donation would appear to be unnecessary for the majority of men and the blood loss advantage traditionally associated with perineal RP is no longer evident.

Duke Scholars

Published In

Urol Oncol

DOI

ISSN

1078-1439

Publication Date

2003

Volume

21

Issue

6

Start / End Page

447 / 455

Location

United States

Related Subject Headings

  • Urology & Nephrology
  • United States Government Agencies
  • United States
  • Retrospective Studies
  • Prostatic Neoplasms
  • Prostatectomy
  • Prostate-Specific Antigen
  • Middle Aged
  • Male
  • Lymph Nodes
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Moul, J. W., Sun, L., Wu, H., McLeod, D. G., Amling, C., Lance, R., … Donahue, T. (2003). Factors associated with blood loss during radical prostatectomy for localized prostate cancer in the prostate-specific antigen (PSA)-era: an overview of the Department of Defense (DOD) Center for Prostate Disease Research (CPDR) national database. Urol Oncol, 21(6), 447–455. https://doi.org/10.1016/s1078-1439(03)00056-5
Moul, Judd W., Leon Sun, Hongyu Wu, David G. McLeod, Christopher Amling, Raymond Lance, John Foley, et al. “Factors associated with blood loss during radical prostatectomy for localized prostate cancer in the prostate-specific antigen (PSA)-era: an overview of the Department of Defense (DOD) Center for Prostate Disease Research (CPDR) national database.Urol Oncol 21, no. 6 (2003): 447–55. https://doi.org/10.1016/s1078-1439(03)00056-5.
Journal cover image

Published In

Urol Oncol

DOI

ISSN

1078-1439

Publication Date

2003

Volume

21

Issue

6

Start / End Page

447 / 455

Location

United States

Related Subject Headings

  • Urology & Nephrology
  • United States Government Agencies
  • United States
  • Retrospective Studies
  • Prostatic Neoplasms
  • Prostatectomy
  • Prostate-Specific Antigen
  • Middle Aged
  • Male
  • Lymph Nodes