Abstract
Objective: To assess the prognosis associated with blood transfusion alone and in combination with adjuvant perioperative chemotherapy in patients with colorectal cancer. Design: Univariate and multivariate retrospective analyses of survival associated with blood transfusion in patients who had taken part in a randomised multicentre trial (SAKK 40/81). Setting: Swiss Group for Clinical Cancer Research (SAKK). Subjects: 450 patients, 104 of whom (23%) did not have a blood transfusion and 346 of whom (77%) did. Interventions: Resection of colorectal cancer and portal infusion of adjuvant chemotherapy. Main outcome measures: Disease-free and overall survival. Results: The median follow-up was 9 years, and patients who had received transfusions had significantly shorter disease-free survival time (hazard ratio (HR) = 1.60; 95% CI 1.12 to 2.38). The transfusion of more than 4 units of blood products was associated with a significantly higher risk (HR = 2.52; 95% CI 1.43 to 4.44). Patients who had no transfusion and who had been assigned to have portal infusion of chemotherapy had a significantly longer disease-free survival time than patients who had transfusion but no chemotherapy (HR = 0.38; 95% CI 0.19 to 0.77). Conclusions: There was an adverse association between blood transfusion and disease-free survival. Patients given perioperative intraportal chemotherapy but no transfusion had the best disease-free survival. We recommend restricting the use of blood transfusions in patients with colorectal cancer.
Original language | English |
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Pages (from-to) | 693-701 |
Number of pages | 9 |
Journal | European Journal of Surgery, Acta Chirurgica |
Volume | 163 |
Issue number | 9 |
Publication status | Published - 1997 |
Keywords
- Adjuvant portal chemotherapy
- Blood transfusion
- Colorectal cancer
- Curative surgery
- Randomised trial
ASJC Scopus subject areas
- Surgery