Association between blood transfusion and survival in a randomised multicentre trial of perioperative adjuvant portal chemotherapy in patients with colorectal cancer

Urban Laffer, Felix Harder, Peter Jäggi, Rudolf Maibach, Shu Fang Hsu Schmitz, Urs Metzger, Monica Castiglione, Peter Aeberhard, Rudolf Egeli, Sergio Arma, Jean Pierre Barras, Veronique Dupont Lampert, Sebastiane Martinoli, Walter Müller, Rudolf Schröder, Rudolf Von Huben, Walter Weber, Aron Goldhirsch, Rudolph Maibach, Friedrich GloorBernhard Stamm, Ursula Waltzer

Research output: Contribution to journalArticlepeer-review

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 languageEnglish
Pages (from-to)693-701
Number of pages9
JournalEuropean Journal of Surgery, Acta Chirurgica
Volume163
Issue number9
Publication statusPublished - 1997

Keywords

  • Adjuvant portal chemotherapy
  • Blood transfusion
  • Colorectal cancer
  • Curative surgery
  • Randomised trial

ASJC Scopus subject areas

  • Surgery

Fingerprint Dive into the research topics of 'Association between blood transfusion and survival in a randomised multicentre trial of perioperative adjuvant portal chemotherapy in patients with colorectal cancer'. Together they form a unique fingerprint.

Cite this