Skip to main content
NCBI home page
Annals of Surgery logoLink to Annals of Surgery
. 1992 Dec;216(6):633–638. doi: 10.1097/00000658-199212000-00004

The association of perioperative blood transfusion with colorectal cancer recurrence.

P I Tartter 1
PMCID: PMC1242709  PMID: 1466616

Abstract

The relationship between blood transfusion, disease-free survival, and other potential prognostic factors was prospectively studied in 339 consecutive patients with colorectal cancer. Admission and discharge hematocrit, Dukes' stage, and blood loss were significantly related to both blood transfusion and disease-free survival. Using Cox proportional hazards model, however, the association of transfusion with disease-free survival was significant (p = 0.0196) after controlling for age, sex, blood loss, procedure, tumor differentiation, stage, admission hematocrit, duration of surgery, length of the specimen, and tumor size. Dukes' stage (p < 0.0001) and blood transfusion (p < 0.0001) were the only variables independently related to disease-free survival. Forty per cent (44) of the 110 patients who received transfusions developed cancer recurrence, compared with 22% (50) of the 229 patients who did not receive blood (p < 0.0001). Five-year disease-free survival of the transfused patients was 57%, compared with 77% for nontransfused patients. Patients who developed recurrence received an average of twice as much blood as patients without recurrence (1.26 versus 0.61 units, p = 0.0128). Perioperative blood transfusion is a significant independent prognostic factor for colorectal cancer.

Full text

PDF
633

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Arnoux R., Corman J., Péloquin A., Smeesters C., St-Louis G. Adverse effect of blood transfusions on patient survival after resection of rectal cancer. Can J Surg. 1988 Mar;31(2):121–126. [PubMed] [Google Scholar]
  2. Bentzen S. M., Balslev I., Pedersen M., Teglbjaerg P. S., Hanberg-Sørensen F., Bone J., Jacobsen N. O., Sell A., Overgaard J., Bertelsen K. Blood transfusion and prognosis in Dukes' B and C colorectal cancer. Eur J Cancer. 1990 Apr;26(4):457–463. doi: 10.1016/0277-5379(90)90016-m. [DOI] [PubMed] [Google Scholar]
  3. Beynon J., Davies P. W., Billings P. J., Channer J. L., Protheroe D., Umpleby H. C., Mortensen N. J., Williamson R. C. Perioperative blood transfusion increases the risk of recurrence in colorectal cancer. Dis Colon Rectum. 1989 Nov;32(11):975–979. doi: 10.1007/BF02552276. [DOI] [PubMed] [Google Scholar]
  4. Blair R., Newsome F. Involvement of water-soluble vitamins in diseases of swine. J Anim Sci. 1985 Jun;60(6):1508–1517. doi: 10.2527/jas1985.6061508x. [DOI] [PubMed] [Google Scholar]
  5. Blumberg N., Agarwal M. M., Chuang C. Relation between recurrence of cancer of the colon and blood transfusion. Br Med J (Clin Res Ed) 1985 Apr 6;290(6474):1037–1039. doi: 10.1136/bmj.290.6474.1037. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Blumberg N., Heal J. M., Murphy P., Agarwal M. M., Chuang C. Association between transfusion of whole blood and recurrence of cancer. Br Med J (Clin Res Ed) 1986 Aug 30;293(6546):530–533. doi: 10.1136/bmj.293.6546.530. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Blumberg N., Heal J. M. Perioperative blood transfusion and solid tumor recurrence--a review. Cancer Invest. 1987;5(6):615–625. doi: 10.3109/07357908709020321. [DOI] [PubMed] [Google Scholar]
  8. Burrows L., Tartter P., Aufses A. Increased recurrence rates in perioperatively transfused colorectal malignancy patients. Cancer Detect Prev. 1987;10(5-6):361–369. [PubMed] [Google Scholar]
  9. CUTLER S. J., EDERER F. Maximum utilization of the life table method in analyzing survival. J Chronic Dis. 1958 Dec;8(6):699–712. doi: 10.1016/0021-9681(58)90126-7. [DOI] [PubMed] [Google Scholar]
  10. Cheslyn-Curtis S., Fielding L. P., Hittinger R., Fry J. S., Phillips R. K. Large bowel cancer: the effect of perioperative blood transfusion on outcome. Ann R Coll Surg Engl. 1990 Jan;72(1):53–59. [PMC free article] [PubMed] [Google Scholar]
  11. Corman J., Arnoux R., Péloquin A., St-Louis G., Smeesters C., Giroux L. Blood transfusions and survival after colectomy for colorectal cancer. Can J Surg. 1986 Sep;29(5):325–329. [PubMed] [Google Scholar]
  12. Creasy T. S., Veitch P. S., Bell P. R. A relationship between perioperative blood transfusion and recurrence of carcinoma of the sigmoid colon following potentially curative surgery. Ann R Coll Surg Engl. 1987 May;69(3):100–103. [PMC free article] [PubMed] [Google Scholar]
  13. Foster R. S., Jr, Costanza M. C., Foster J. C., Wanner M. C., Foster C. B. Adverse relationship between blood transfusions and survival after colectomy for colon cancer. Cancer. 1985 Mar 15;55(6):1195–1201. doi: 10.1002/1097-0142(19850315)55:6<1195::aid-cncr2820550610>3.0.co;2-h. [DOI] [PubMed] [Google Scholar]
  14. Francis D. M., Judson R. T. Blood transfusion and recurrence of cancer of the colon and rectum. Br J Surg. 1987 Jan;74(1):26–30. doi: 10.1002/bjs.1800740110. [DOI] [PubMed] [Google Scholar]
  15. Graves T. A., Cioffi W. G., Mason A. D., Jr, McManus W. F., Pruitt B. A., Jr Relationship of transfusion and infection in a burn population. J Trauma. 1989 Jul;29(7):948–954. doi: 10.1097/00005373-198907000-00007. [DOI] [PubMed] [Google Scholar]
  16. Hermanek P., Jr, Guggenmoos-Holzmann I., Schricker K. T., Resch T., Freudenberger K., Neidhardt P., Gall F. P. Der Einfluss der Transfusion von Blut und Haemoderivaten auf die Prognose des colorectalen Carcinoms. Langenbecks Arch Chir. 1989;374(2):118–124. doi: 10.1007/BF01261621. [DOI] [PubMed] [Google Scholar]
  17. Marsh J., Donnan P. T., Hamer-Hodges D. W. Association between transfusion with plasma and the recurrence of colorectal carcinoma. Br J Surg. 1990 Jun;77(6):623–626. doi: 10.1002/bjs.1800770609. [DOI] [PubMed] [Google Scholar]
  18. Mecklin J. P., Järvinen H. J., Ovaska J. T. Blood transfusion and prognosis in colorectal carcinoma. Scand J Gastroenterol. 1989 Jan;24(1):33–39. doi: 10.3109/00365528909092236. [DOI] [PubMed] [Google Scholar]
  19. Nathanson S. D., Tilley B. C., Schultz L., Smith R. F. Perioperative allogeneic blood transfusions. Survival in patients with resected carcinomas of the colon and rectum. Arch Surg. 1985 Jun;120(6):734–738. doi: 10.1001/archsurg.1985.01390300076013. [DOI] [PubMed] [Google Scholar]
  20. Ota D., Alvarez L., Lichtiger B., Giacco G., Guinee V. Perioperative blood transfusion in patients with colon carcinoma. Transfusion. 1985 Jul-Aug;25(4):392–394. doi: 10.1046/j.1537-2995.1985.25485273825.x. [DOI] [PubMed] [Google Scholar]
  21. Parrott N. R., Lennard T. W., Taylor R. M., Proud G., Shenton B. K., Johnston I. D. Effect of perioperative blood transfusion on recurrence of colorectal cancer. Br J Surg. 1986 Dec;73(12):970–973. doi: 10.1002/bjs.1800731208. [DOI] [PubMed] [Google Scholar]
  22. Persijn G. G., Cohen B., Lansbergen Q., van Rood J. J. Retrospective and prospective studies on the effect of blood transfusions in renal transplantation in The Netherlands. Transplantation. 1979 Nov;28(5):396–401. doi: 10.1097/00007890-197911000-00010. [DOI] [PubMed] [Google Scholar]
  23. Ross W. B. Blood transfusion and colorectal cancer. J R Coll Surg Edinb. 1987 Aug;32(4):197–201. [PubMed] [Google Scholar]
  24. Tartter P. I. Blood transfusion and postoperative infections. Transfusion. 1989 Jun;29(5):456–459. doi: 10.1046/j.1537-2995.1989.29589284149.x. [DOI] [PubMed] [Google Scholar]
  25. Tartter P. I., Francis D. M. Blood transfusion and tumor growth. Transplant Proc. 1988 Dec;20(6):1108–1111. [PubMed] [Google Scholar]
  26. Tartter P. I., Martinelli G. Lymphocyte subsets, natural killer cytotoxicity, and perioperative blood transfusion for elective colorectal cancer surgery. Cancer Detect Prev Suppl. 1987;1:571–576. [PubMed] [Google Scholar]
  27. Vente J. P., Wiggers T., Weidema W. F., Jeekel J., Obertop H. Peri-operative blood transfusions in colorectal cancer. Eur J Surg Oncol. 1989 Aug;15(4):371–374. [PubMed] [Google Scholar]
  28. Voogt P. J., van de Velde C. J., Brand A., Hermans J., Stijnen T., Bloem R., Leer J. W., Zwaveling A., van Rood J. J. Perioperative blood transfusion and cancer prognosis. Different effects of blood transfusion on prognosis of colon and breast cancer patients. Cancer. 1987 Feb 15;59(4):836–843. doi: 10.1002/1097-0142(19870215)59:4<836::aid-cncr2820590430>3.0.co;2-s. [DOI] [PubMed] [Google Scholar]
  29. Waymack J. P., Alexander J. W. Blood transfusions as an immunomodulator--a review. Comp Immunol Microbiol Infect Dis. 1986;9(2-3):177–183. doi: 10.1016/0147-9571(86)90010-x. [DOI] [PubMed] [Google Scholar]
  30. Waymack J. P., Moomaw C. J., Popp M. B. The effect of perioperative blood transfusions on long-term survival of colon cancer patients. Mil Med. 1989 Oct;154(10):515–517. [PubMed] [Google Scholar]
  31. Weiden P. L., Bean M. A., Schultz P. Perioperative blood transfusion does not increase the risk of colorectal cancer recurrence. Cancer. 1987 Aug 15;60(4):870–874. doi: 10.1002/1097-0142(19870815)60:4<870::aid-cncr2820600425>3.0.co;2-0. [DOI] [PubMed] [Google Scholar]
  32. Wirsching R. P., Demmel N., Liewald F., Mempel W., Zwingers N. Einfluss der Bluttransfusion auf Tumorrückfall und Uberlebensrate beim colorectalen carcinom. Chirurg. 1988 Oct;59(10):647–653. [PubMed] [Google Scholar]
  33. Wobbes T., Joosen K. H., Kuypers H. H., Beerthuizen G. I., Theeuwes G. M. The effect of packed cells and whole blood transfusions on survival after curative resection for colorectal carcinoma. Dis Colon Rectum. 1989 Sep;32(9):743–748. doi: 10.1007/BF02562121. [DOI] [PubMed] [Google Scholar]

Articles from Annals of Surgery are provided here courtesy of Lippincott, Williams, and Wilkins

RESOURCES