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 journal › Article

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

Fingerprint

Adjuvant Chemotherapy
Blood Transfusion
Multicenter Studies
Colorectal Neoplasms
Survival
Disease-Free Survival
Drug Therapy
Hematologic Diseases
Multivariate Analysis
Odds Ratio
Outcome Assessment (Health Care)
Research
Neoplasms

Keywords

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

ASJC Scopus subject areas

  • Surgery

Cite this

Association between blood transfusion and survival in a randomised multicentre trial of perioperative adjuvant portal chemotherapy in patients with colorectal cancer. / Laffer, Urban; Harder, Felix; Jäggi, Peter; Maibach, Rudolf; Schmitz, Shu Fang Hsu; Metzger, Urs; Castiglione, Monica; Aeberhard, Peter; Egeli, Rudolf; Arma, Sergio; Barras, Jean Pierre; Lampert, Veronique Dupont; Martinoli, Sebastiane; Müller, Walter; Schröder, Rudolf; Von Huben, Rudolf; Weber, Walter; Goldhirsch, Aron; Maibach, Rudolph; Gloor, Friedrich; Stamm, Bernhard; Waltzer, Ursula.

In: European Journal of Surgery, Acta Chirurgica, Vol. 163, No. 9, 1997, p. 693-701.

Research output: Contribution to journal › Article

Laffer, U, Harder, F, Jäggi, P, Maibach, R, Schmitz, SFH, Metzger, U, Castiglione, M, Aeberhard, P, Egeli, R, Arma, S, Barras, JP, Lampert, VD, Martinoli, S, Müller, W, Schröder, R, Von Huben, R, Weber, W, Goldhirsch, A, Maibach, R, Gloor, F, Stamm, B & Waltzer, U 1997, 'Association between blood transfusion and survival in a randomised multicentre trial of perioperative adjuvant portal chemotherapy in patients with colorectal cancer', European Journal of Surgery, Acta Chirurgica, vol. 163, no. 9, pp. 693-701.
Laffer U, Harder F, Jäggi P, Maibach R, Schmitz SFH, Metzger U et al. Association between blood transfusion and survival in a randomised multicentre trial of perioperative adjuvant portal chemotherapy in patients with colorectal cancer. European Journal of Surgery, Acta Chirurgica. 1997;163(9):693-701.
Laffer, Urban ; Harder, Felix ; Jäggi, Peter ; Maibach, Rudolf ; Schmitz, Shu Fang Hsu ; Metzger, Urs ; Castiglione, Monica ; Aeberhard, Peter ; Egeli, Rudolf ; Arma, Sergio ; Barras, Jean Pierre ; Lampert, Veronique Dupont ; Martinoli, Sebastiane ; Müller, Walter ; Schröder, Rudolf ; Von Huben, Rudolf ; Weber, Walter ; Goldhirsch, Aron ; Maibach, Rudolph ; Gloor, Friedrich ; Stamm, Bernhard ; Waltzer, Ursula. / Association between blood transfusion and survival in a randomised multicentre trial of perioperative adjuvant portal chemotherapy in patients with colorectal cancer. In: European Journal of Surgery, Acta Chirurgica. 1997 ; Vol. 163, No. 9. pp. 693-701.
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title = "Association between blood transfusion and survival in a randomised multicentre trial of perioperative adjuvant portal chemotherapy in patients with colorectal cancer",
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.",
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author = "Urban Laffer and Felix Harder and Peter J{\"a}ggi and Rudolf Maibach and Schmitz, {Shu Fang Hsu} and Urs Metzger and Monica Castiglione and Peter Aeberhard and Rudolf Egeli and Sergio Arma and Barras, {Jean Pierre} and Lampert, {Veronique Dupont} and Sebastiane Martinoli and Walter M{\"u}ller and Rudolf Schr{\"o}der and {Von Huben}, Rudolf and Walter Weber and Aron Goldhirsch and Rudolph Maibach and Friedrich Gloor and Bernhard Stamm and Ursula Waltzer",
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T1 - Association between blood transfusion and survival in a randomised multicentre trial of perioperative adjuvant portal chemotherapy in patients with colorectal cancer

AU - Laffer, Urban

AU - Harder, Felix

AU - Jäggi, Peter

AU - Maibach, Rudolf

AU - Schmitz, Shu Fang Hsu

AU - Metzger, Urs

AU - Castiglione, Monica

AU - Aeberhard, Peter

AU - Egeli, Rudolf

AU - Arma, Sergio

AU - Barras, Jean Pierre

AU - Lampert, Veronique Dupont

AU - Martinoli, Sebastiane

AU - Müller, Walter

AU - Schröder, Rudolf

AU - Von Huben, Rudolf

AU - Weber, Walter

AU - Goldhirsch, Aron

AU - Maibach, Rudolph

AU - Gloor, Friedrich

AU - Stamm, Bernhard

AU - Waltzer, Ursula

PY - 1997

Y1 - 1997

N2 - 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.

AB - 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.

KW - Adjuvant portal chemotherapy

KW - Blood transfusion

KW - Colorectal cancer

KW - Curative surgery

KW - Randomised trial

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C2 - 9311477

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JO - European Journal of Surgery, Acta Chirurgica

JF - European Journal of Surgery, Acta Chirurgica

SN - 1102-4151

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