Abstract
The aim of the present study was to determine whether allogeneic red blood cell transfusions showed a deleterious effect and what might be preoperative risk factors for blood transfusion in patients with TNM stage II colon cancer. Total 470 patients who fulfilled inclusion criteria were selected for a further 10-year follow-up study. We found that there were statistical significance between non-transfused and transfused group in mortality (P=0.018), local recurrence (P=0.000) and distant metastasis (P=0.040). Local recurrence and distant metastasis between 1 to 3 units and more than 3 units group did not show any significant differences. There was no difference in survival rate between non-transfused and 1 to 3 units group (log rank =0.031, P=0.860). The difference between different blood transfusion volume in transfused patients was found (78.77% vs 63.83%, P=0.006). Meanwhile, the significant difference of survival rate was existed between non-transfused group and more than 3 units group (84.83% vs 63.83%, P=0.002 ). Univariate analysis showed the following 3 variables to be associated with an increased risk of allogeneic blood transfusions: preoperative CEA level (P<0.05), location of tumor (P<0.01) and diameter of tumor (P<0.01). Multivariate analysis revealed that location of tumor and diameter of tumor are two independent factors for requirement of perioperative transfusions. Therefore, allogeneic transfusion increase the postoperative tumor mortality, local recurrence and distant metastasis in patients with stage II colon cancer. The postoperative tumor mortality, local recurrence and distant metastasis were not associated with the blood transfusion volume. The blood transfusion volume was associated with the survival rate. Location of tumor and diameter of tumor were the independent preoperative risk factors for blood transfusion.
Highlights
Perioperative allogeneic red blood cell transfusion (ABT) is frequently administered for patients undergoing colorectal resection for cancer
The aim of the present study was to determine whether allogeneic red blood cell transfusions showed a deleterious effect and what might be preoperative risk factors for blood transfusion in patients with TNM stage II colon cancer
We found that there were statistical significance between non-transfused and transfused group in mortality (P=0.018), local recurrence (P=0.000) and distant metastasis (P=0.040)
Summary
Perioperative allogeneic red blood cell transfusion (ABT) is frequently administered for patients undergoing colorectal resection for cancer. Allogeneic blood transfusion was one of the factors on prognosis of colorectal cancer (CRC) in many possible factors (van der Voort van Zijp et al, 2008). It has been reported that allogeneic blood transfusion may potentially increase postoperative tumor recurrence and mortality (Chung et al, 1993; Vamvakas, 1995; Amato et al, 2006). The effect of allogeneic blood transfusion is difficult to describe, because the previous studies all have included all cases without considering the effect of allogeneic blood transfusion might be influenced by different TNM stage. CRC stage was considered as an important factors for recurrence (Compton et al, 2000; Kobayashi et al, 2007; Aghili et al, 2010)
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