Perioperative blood transfusion increases the risk of recurrence in colorectal cancer

Abstract

A retrospective study was conducted on 519 patients undergoing curative resection for colorectal carcinoma between 1969 and 1980. Recurrence was diagnosed in 214 patients (41.2 percent), 179 of whom (34.5 percent) had received blood transfusions and 35 of whom (6.7 percent) had not (P less than .001). Exclusion of the right-sided colonic tumors still showed that recurrence was more common in transfused than nontransfused patients (135 [47.2 percent] vs. 25 [22.5 percent]; P less than .001). Recurrence in patients transfused only during surgery (N = 201) was higher than in nontransfused patients (P less than .001) and, similarly, all patients transfused during surgery (N = 297) had an increased risk (P less than .001). Among patients with rectal cancer, transfusion increased the risk of recurrence in those treated by abdominoperineal resection (P less than .02), but this was not the case in those treated by sphincter-saving resection (P = .2). Hierarchical log linear analysis of all dependent factors (Dukes' stage, histologic grade, age, sex, site, elective, or emergency procedure) showed that Dukes' stage and blood transfusion had the most significant effects on the development of recurrence (chi 2 = 54.04, df = 6, P less than .0001 and chi 2 = 13.93, df = 3, P less than .003). The risk of recurrence following curative surgery for colorectal cancer is markedly increased by blood transfusion on the day of operation.

The impact of comorbidity on the overall survival and the cause of death in patients after colorectal cancer resection

“…Blood transfusion has been reported to favor cancer recurrence and curtail survival after curative cancer resection [1,2,3,4,5,6]. Meta-analyses by Chung et al.…”

The Effects of Anemia and Blood Transfusion on Patients With Stage III-IV Ovarian Cancer

“…8Y10,17 Initial studies in renal transplant patients suggested a benefit from an altered immune function. 22,28 Gastrointestinal cancers are well studied with regard to transfusions. Transfusions have been associated with an increased rate of recurrence and death from malignancy in colorectal cancer.…”

The Immunosuppressive Aspects of Blood Transfusion

“…recurrence and cancer-related mortality persisted for transfused patients. Another study also analyzed patients with colonic tumors and rectal tumors separately [53]. In both groups, blood transfusion was associated with a significantly increased recurrence rate.…”