Effect of perioperative blood transfusion on recurrence of colorectal cancer

Abstract

The aim of the present study was to examine the outcome of 517 patients undergoing curative surgery for colonic and rectal cancer, and to compare the recurrence and mortality rates in transfused and non-transfused groups of patients. The two groups were evenly matched for age, sex, Dukes' stage and histological differentiation. There were significantly more rectal tumours in the transfused group (P less than 0.01), but the distribution of colonic lesions did not differ. Life table analysis revealed that the transfused patients had a 20 per cent greater probability of recurrence at 5 years (P less than 0.005) and there were 16 per cent more cancer related deaths (P less than 0.01). Even when all rectal cancers were excluded, a similar trend was seen for the colonic lesions: a 24 per cent greater probability of recurrence at 5 years (P less than 0.025) and 15 per cent more cancer related deaths (P less than 0.02). We conclude that blood transfusion may be associated with increased mortality and recurrence in patients undergoing curative surgery for colorectal cancer.

Effects of blood transfusion with leucocyte depletion on length of hospital stay, respiratory assistance and survival after curative surgery for colorectal cancer

“…Previous retrospective studies, reporting decreased long-term survival and shorter time-interval to tumour recurrence, led to the assumption of direct negative effects of blood transfusions on patient prognosis after surgery for malignant disease [4]. The most commonly proposed mechanism has been immunosuppression through transfused allogeneic leucocytes [6].…”

“…Increased risk of postoperative infectious complications [2] and fewer acute episodes of Crohn's disease have also been reported after blood transfusion [3]. Several retrospective studies have indicated decreased long-term survival in patients receiving transfusion of blood products in connection with cancer surgery [2,4,5]. Immunosuppression through transfused allogeneic leucocytes, which can influence the activity of endogenous NK-cells and change the ratio of T-helper/T-suppressor cells, has been suggested as a possible mechanism [6].…”

Perioperative Blood Transfusions and Prognosis in Patients with Curatively Resected Locally Advanced Gastric Cancer

“…The adverse effect of perioperative blood transfusions has been studied in patients with breast cancer [3,4], lung cancer [5,6], soft tissue sarcoma [7], renal cell carcinoma [8], head and neck cancer [9], and most frequently in colo rectal cancer [10][11][12][13][14], Contradictory results have been reported on the effects of perioperative blood transfusions on the prognosis of patients with gastric cancer treated surgically [15][16][17], Therefore, we have undertaken an analysis to investi gate the relationship between perioperative blood transfu-sions and survival of patients with curatively resected locally advanced gastric cancer, which is the most com mon malignancy in Korea [18].…”

The Effect of Previous Blood Transfusion on Lymphocyte Subsets and Natural Killer Cell Function in Patients with Colorectal Cancer

“…The possible widespread alterations in the immune system have been the subject of numerous investigations in animal models as well as in humans [1][2][3][4][5][6][7], The effect of blood transfusion may be beneficial, as described in the The cause of immune modulations is unclarified, but ap pears to involve active suppression of both specific and non specific immune responses. The mechanism by which blood or its components mediate these effects also remains to be clarified, although recipients of whole blood and/or packed red blood cells have been reported as having better kidney graft survival than recipients of washed blood [13], and recipients with different malignant neoplasms trans fused with whole blood had a significantly higher recur rence rate shown by multifactorial analysis to be independ ent of other known prognostic factors [14], This conclusion was supported by some other reports [15][16][17], whereas still others could not add support to this hypothesis [18][19][20][21],…”