Abstract
(1) Background: Anaemia is a common finding in patients with colon cancer and is commonly corrected by blood transfusion prior to surgery. However, the prognostic role of perioperative transfusions is still debated. The aim of the present study was to investigate the role of preoperative anaemia and preoperative blood transfusion in influencing the prognosis in colon cancer. (2) Patients and Methods: Patients undergoing elective surgery for colon cancer at a tertiary referral university hospital between January 2010 and December 2018 were included in a retrospective review of a prospectively collected database. Univariate and regression analyses were performed to identify the prognostic role of preoperative anaemia and preoperative transfusions in this homogeneous cohort of patients. (3) Results: A total of 780 patients were included in the final analysis. The estimated five-year overall survival rate was significantly worse in the anaemic group (83.8% in non-anaemic patients, 60.6% in mild anaemic patients, 61.3% in moderate anaemic patients and 58.4% in severe anaemic patients; log-rank < 0.001 vs. non-anaemic patients). Anaemic status was found to be an independent adverse prognostic factor (hazard ratio (HR): 1.46; 95% confidence interval (CI): 1.02–2.07) during multivariate analysis. Among moderate to severe anaemic patients, no significant association was found between preoperative transfusions and the risk of mortality or recurrence. (4) Conclusions: Preoperative anaemia, regardless of its severity, and not preoperative blood transfusion, was independently associated with a worse prognosis after surgery in patients with colonic cancer.
Highlights
Colon cancer is the third-most common cancer in men and the second-most common cancer in women [1].anaemia is a common finding in patients with digestive tract tumors, with an incidence approaching 70% during the natural history of colon cancer [2].The main mechanisms for anaemia include tumour bleeding and reduced iron uptake and use rates [3]
(3) Results: A total of 780 patients were included in the final analysis
Several other studies reported that there was no significant association between blood transfusions and surgery-related complications or overall or disease-free survival after colon cancer resection [10,11,12]
Summary
Colon cancer is the third-most common cancer in men and the second-most common cancer in women [1].anaemia is a common finding in patients with digestive tract tumors, with an incidence approaching 70% during the natural history of colon cancer [2].The main mechanisms for anaemia include tumour bleeding and reduced iron uptake and use rates [3]. Anaemia is a common finding in patients with digestive tract tumors, with an incidence approaching 70% during the natural history of colon cancer [2]. Anaemia at the time of diagnosis has been associated with a greater risk of tumour recurrence and dismal long-term survival [4,5,6]. Anaemia can be corrected by perioperative allogeneic blood transfusions even though their application is thought by some to have immunosuppressive and proinflammatory effects, with possible adverse consequences on postoperative morbidity and long-term prognosis among colon cancer patients [7,8,9]. Several other studies reported that there was no significant association between blood transfusions and surgery-related complications or overall or disease-free survival after colon cancer resection [10,11,12]
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