Effects of the combination of blood transfusion and postoperative infectious complications on prognosis after surgery for colorectal cancer

Mynster, Tommie; Christensen, I. J.; Moesgaard, F; Nielsen, Hans Jørgen

doi:10.1046/j.1365-2168.2000.01570.x

Cited by 163 publications

(114 citation statements)

References 33 publications

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“…Similarly, development of postoperative infectious complications is also associated with enhanced systemic induction of inflammatory cytokines. Mynster et al [18] shows that a combination of perioperative blood transfusion and subsequent development of postoperative infectious complications may be associated with a poor long-term prognosis in patients after potentially curative resections for colorectal cancer.…”

Section: Discussionmentioning

confidence: 99%

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: 99%

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

et al. 2012

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“…Recent studies have shown that the postoperative complications were risk factors for the survival or disease recurrence in various types of malignancies 7, 8, 9, 10, 11, 12. Furthermore, some authors have shown that the immunological response against postoperative complications enhanced the viability of undetectable residual tumor cells after surgery, thereby increasing the risk of disease recurrence 13, 14.…”

Section: Introductionmentioning

confidence: 99%

Impact of postoperative complications on the colorectal cancer survival and recurrence: analyses of pooled individual patients’ data from three large phase III randomized trials

et al. 2017

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This study assessed the impact of postoperative complications on the colorectal cancer survival and recurrence after curative surgery using pooled individual patients’ data from three large phase III randomized trials. In total, 5530 patients were included in this study. The patients were classified as those with postoperative complications (C group) and those without postoperative complications (NC group). The risk factors for the overall survival (OS) and the disease‐free survival (DFS) were analyzed. Postoperative complications were found in 861 (15.6%) of the 5530 patients. The OS and DFS rates at 5 years after surgery were 68.9% and 74.8%, respectively, in the C group and 75.8% and 82.2%, respectively, in the NC group, values that were significantly different between the two groups (P < 0.001). The multivariate analysis demonstrated that postoperative complications were a significant independent risk factor for the OS and DFS. Postoperative complications can worsen the colorectal cancer survival and risk of recurrence. Surgical morbidity must be considered as a stratification factor in future phase III trials evaluating the effects of adjuvant chemotherapy on colorectal cancer.

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“…Many previous studies [1][2][3][4][5][6][7][8][9] have demonstrated that the development of postoperative complications increased the risk of disease recurrence in various types of malignancies. Among surgical morbidities, infectious complications are the most frequent and directly related to surgery.…”

Section: Introductionmentioning

confidence: 99%

“…Among surgical morbidities, infectious complications are the most frequent and directly related to surgery. Some authors [5,9,10] have suggested that the immunological response against postoperative infection enhanced the viability of undetectable residual tumor cells after surgery, thereby increasing disease recurrence.…”

Section: Introductionmentioning

confidence: 99%

Impact of infectious complications on gastric cancer recurrence

et al. 2014

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Background Postoperative infectious complications increase disease recurrence in colorectal cancer patients. We herein investigated the impact of infectious complications on gastric cancer recurrence after curative surgery. Methods In total, 502 patients who underwent R0 resection for gastric cancer were reviewed. Patients were classified into those with infectious complications (IC group) and those without infectious complications (NO group). The risk factors for recurrence-free survival (RFS) were identified. Results Infectious complications, which occurred in 52 patients (10.4 %), included pneumonia, ileus with a systemic inflammatory reaction, anastomotic leakage, and intraperitoneal abscess. The overall 5-year RFS rate was 83 % in the NO group and 58 % in the IC group (p = 0.000). Multivariate analysis demonstrated that age, ASA score, stage, and infectious complications were significant predictors of RFS. Conclusions Infectious complications were a risk factor for gastric cancer recurrence. To avoid causing infectious complications, the surgical procedure, surgical strategy, and perioperative care should be carefully planned.

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Effects of the combination of blood transfusion and postoperative infectious complications on prognosis after surgery for colorectal cancer

Abstract: Blood transfusion per se may not be a risk factor for poor prognosis after colorectal cancer surgery. However, the combination of perioperative blood transfusion and subsequent development of postoperative infectious complications may be associated with a poor prognosis.

Cited by 163 publications

References 33 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

Impact of postoperative complications on the colorectal cancer survival and recurrence: analyses of pooled individual patients’ data from three large phase III randomized trials

Impact of infectious complications on gastric cancer recurrence

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