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

Skånberg, Jan; Lundholm, Kent; Haglind, Eva

doi:10.1080/02841860701441830

Cited by 44 publications

(34 citation statements)

References 23 publications

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“…In a multicentric randomized trial, Lange et al [12] compared the use of leukocyte-depleted and buffy-coat-depleted blood and found no improvement in five-year overall survival, disease-free survival, and tumor recurrences in patients with gastrointestinal cancer. Similarly, van de Watering [13] and Skånberg [14] in other prospective randomized trials, designed specifically for colorectal cancer, showed no significant effect of leukocyte depletion on overall five-year survival and cancer recurrence. In all these studies, the prognosis of patients who received blood transfusion, regardless of their type, was significantly worse compared with non-transfused patients.…”

Section: Discussionmentioning

confidence: 90%

Impact of Blood Transfusions on Survival and Recurrence in Colorectal Cancer Surgery

et al. 2012

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The aim of our study was to evaluate the prognostic significance of blood transfusion on recurrence and survival in patients undergoing curative resections for colorectal cancer. Retrospective analysis of prospectively collected data of patients after elective resections for colorectal cancer between January 2001 and December 2009 was undertaken. The main endpoint was overall survival, disease-free survival, and recurrence rate. These data were evaluated in relation to blood transfusion (group A, no blood transfusion; group B, one to two blood transfusions; group C, three and more blood transfusions). A total of 583 patients met the criteria for inclusion in the study. Of these, 132 (22.6 %) patients received blood transfusion in the perioperative period. There were 83 (14.2 %) patients who received one or two blood transfusions and 49 (8.4 %) patients who required three or more transfusions. Patients with three or more transfusions had a significantly worse 5-year overall survival, disease-free survival, and increased incidence of distant recurrences in comparison with the group without transfusion or the group with one or two transfusions. Multivariate analysis showed that the application of three or more blood transfusions is an independent risk factor for overall survival (P 00.001; HR 2.158; 95 % CI 1.370-3.398), disease-free survival (P<0.001; HR 2.514; 95 % CI 1.648-3.836), and the incidence of distant recurrence (P<0.001; HR 2.902; 95 % CI 1.616-5.212). Application of three or more blood transfusions in patients operated for colorectal carcinoma is an adverse prognostic factor. Indications for blood transfusion should be carefully considered not only with regard to the risk of early complications, but also because of the possibility of compromising long-term results.

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Section: Discussionmentioning

confidence: 90%

Impact of Blood Transfusions on Survival and Recurrence in Colorectal Cancer Surgery

et al. 2012

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“…It may also be explained by the complexity of the operation and other operative factors that led to the transfusion in the first place [28]. Others have shown that both whole blood and leukocyte depleted blood transfusions had increased postoperative ventilation rates and prolonged hospital stay [29]. Another study also noted a 5 year survival difference with 72.9 and 59.6% (P < 0.001), respectively for patients not transfused versus those transfused, the cancer recurrence rate was not significantly different [30].…”

Section: Blood Loss and Transfusions In Surgical Oncologymentioning

confidence: 95%

Blood loss in surgical oncology: Neglected quality indicator?

Dixon

Datta

Sutherland

et al. 2009

Journal of Surgical Oncology

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Quality indicators can be defined as "specific and measurable elements of practice that can be used to assess the quality of care". Surgical blood loss is one of the most significant perioperative predictors of patient outcome. Blood loss is a modifiable quality indicator for oncologic cancer surgery. Surgical oncologists need to alter their surgical technique to promote bloodless surgery and decrease the variability in reported blood loss and rates of blood transfusion.

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“…With the aim of minimizing transfusion-associated immunomodulatory effects that induce increased morbidity and poor prognosis in cancer patients, transfusion of leukocyte-depleted packed red blood cells has been studied. However, no significant association has been found between leukocyte-depleted red blood cell transfusion and long-term survival of patients with gastrointestinal cancer [35][36][37][38] . It is possible that leukocyte-depleted blood transfusion has a negative impact: further study is needed.…”

Section: Discussionmentioning

confidence: 99%

Perioperative Blood Transfusion, Age at Surgery, and Prognosis in a Database of 526 Upper Gastrointestinal Cancers

Kosumi

Baba²,

Harada³

et al. 2015

Dig Surg

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Aims: It is demonstrated that older animals have significantly weaker responses to new alloantigen stimulation than young animals, but the effect on prognosis of perioperative blood transfusion in relation to patient age is unknown. This study is retrospective review to investigate the relationship between perioperative blood transfusion, age at surgery, and clinical outcome in upper gastrointestinal cancer patients. Methods: We analyzed data of 526 upper gastrointestinal cancer patients who underwent curative resection from 2005 to 2010. Results: In esophageal cancer patients, patients with blood transfusion experienced significantly shorter overall survival (OS; univariate HR 2.50, p = 0.0006) and disease-free survival (DFS; univariate HR 1.71, p = 0.016) than patients without. Similar results were observed in gastric cancer patients (OS; univariate HR 3.35, p = 0.0001 and DFS; univariate HR = 3.18, p < 0.0001). Furthermore perioperative blood transfusion may be an independent prognostic factor in esophageal cancer patients (multivariate HR = 2.07, p = 0.026). Interestingly, age at surgery significantly affected the influence of blood transfusion on patient outcome in esophageal cancer patients (p for interaction = 0.022). Conclusion: The negative effect of perioperative blood transfusion was particularly evident among younger patients with esophageal cancer.

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

Cited by 44 publications

References 23 publications

Impact of Blood Transfusions on Survival and Recurrence in Colorectal Cancer Surgery

Impact of Blood Transfusions on Survival and Recurrence in Colorectal Cancer Surgery

Blood loss in surgical oncology: Neglected quality indicator?

Perioperative Blood Transfusion, Age at Surgery, and Prognosis in a Database of 526 Upper Gastrointestinal Cancers

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