Effects of perioperative blood transfusion on the prognosis in hereditary and sporadic colon cancer

Abstract

We investigated the effects of perioperative blood transfusion in the prognosis of hereditary and sporadic colon cancer. There are 1075 colon cancer patients, including 936 sporadic colon cancer and 139 with hereditary colon cancer undergoing surgery at our hospital. All patients underwent 10 years of follow-up. In the sporadic group, mortality, local recurrence rate and distant metastases rate of transfused patients were significantly higher than non-transfused patients. The 10-year survival rates were significantly lower in patients receiving blood transfusions compared to non-transfused patients. In the hereditary group, mortality was higher in transfused patients compared to non-transfused patients.

Laparoscopic Versus Open Liver Resection for Colorectal Liver Metastases: A Comprehensive Systematic Review and Meta-analysis

“…This could be a combination of a lower intra-operative blood loss as well as reduced risk of abdominal wall/muscular bleeding in the post-operative period. This is potentially of clinical significance due to the ongoing debate whether blood transfusions (through immunogenicity or otherwise) contribute to worse long-term survival in colorectal cancer 76–79 .…”

Assessing the impact of perioperative blood transfusions on the survival of adults undergoing cytoreductive surgery with hyperthermic intraperitoneal chemotherapy for appendiceal carcinomatosis

“…Although PBTs are beneficial under several clinical circumstances , studies indicate they may also be associated with inflammation and immunosuppression, which may be conducive to tumour spread . Clinically, PBTs have been associated with decreased survival in patients with several malignancies including colorectal, bladder, gastric, liver and ovarian cancers . This association was not found in other studies .…”

Investigating the association between perioperative blood transfusions and outcomes in children undergoing cytoreductive surgery with hyperthermic intraperitoneal chemotherapy

“…Secondly, unlike our study population where only 5% had peritoneal disease of colorectal origin, the majority of patients in the studies where blood transfusions were associated with worse outcomes after CRS–HIPEC had peritoneal carcinomatosis of colorectal origin . This difference may be significant, since other authors have described unfavourable outcomes after blood transfusion during colorectal surgery in different settings . Furthermore, several studies demonstrating an unfavourable or equivocal impact of blood transfusions on oncologic outcomes have been focused on a single pathology, for example colon or bladder cancer .…”

“…This difference may be significant, since other authors have described unfavourable outcomes after blood transfusion during colorectal surgery in different settings . Furthermore, several studies demonstrating an unfavourable or equivocal impact of blood transfusions on oncologic outcomes have been focused on a single pathology, for example colon or bladder cancer . However, our study cohort did not possess a uniform diagnosis, and our results may be more of a reflection of the impact of red blood cell transfusions in the context of CRS–HIPEC in children, other than on the specific diagnoses included.…”

“…Due to the complexity of the surgical procedure, prolonged operative times and perioperative red blood cell transfusions are not uncommon in children undergoing CRS–HIPEC . However, some studies have shown the receipt of a red blood cell transfusion to be associated with worse oncologic outcomes for a number of malignancies including colon, bladder and liver cancers . Immunosuppression resulting from transfusion‐related immunomodulation (TRIM) has been cited as a possible explanation for the increased risk of complications and worse long‐term outcomes after blood transfusion .…”