Abstract
Purpose: To evaluate the effect of perioperative blood transfusions on colorectal cancer recurrence and patient survival. Patients and Methods: A total of 1,051 patients treated with curative surgery for stage II or III colorectal adenocarcinoma were retrospectively studied for the effect of perioperative blood transfusions on disease recurrence and patient survival. Forty-two percent of patients received perioperative blood components. Results: Perioperative transfusions had no effect on disease progression in univariate or multivariate analysis. Tumor stage (P = .0001), locally advanced tumor characteristics (adherence, involvement of adjacent structure, or perforation; P = .0001), location (rectal v colon; P = .0002), grade (P < .001), and cell kinetic profile (nondiploid or high percent synthetic phase [%S] + percent gap 2 mitosis phase [%G2M]; P = .0003) were the most powerful independent predictors of tumor recurrence. Use of transfusions was associated with an adverse effect on overall survival (P < .004) using multivariate analysis, as well as tumor stage (P = .0001), location(P = .004), grade (P = .001), patient age (P = .0001), sex (P < .04), and cell kinetic profile (P = .0001). In further evaluation of the prognostic effects of transfusions, there was no increased risk of disease recurrence after whole-blood transfusions (P = .14) as compared with packed RBC or no transfusions, although the disease-specific survival for patients who received whole blood was lower than for nontransfused patients (P < .005) and patients who received other blood components (P < .03). Conclusion: With transfusion practices that use blood components, most commonly RBCs, medically indicated transfusions to patients with colorectal carcinoma seem to have no impact on disease recurrence. The adverse impact of transfusions on cancer patient survival is more likely due to ether unevaluated tumor variables or underlying illness rather than tumor recurrence enhancement by immunosuppression induced by transfusion of blood components.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 1671-1678 |
| Number of pages | 8 |
| Journal | Journal of Clinical Oncology |
| Volume | 13 |
| Issue number | 7 |
| State | Published - 1995 |
Fingerprint
ASJC Scopus subject areas
- Cancer Research
- Oncology
Cite this
Perioperative blood transfusions do not affect disease recurrence of patients undergoing curative resection of colorectal carcinoma : A Mayo/North Central Cancer Treatment Group study. / Donohue, J. H.; Williams, S.; Cha, S.; Windschitl, H. E.; Witzig, Thomas Elmer; Nelson, Heidi; Fitzgibbons, R. J.; Wieand, H. S.; Moertel, C. G.
In: Journal of Clinical Oncology, Vol. 13, No. 7, 1995, p. 1671-1678.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Perioperative blood transfusions do not affect disease recurrence of patients undergoing curative resection of colorectal carcinoma
T2 - A Mayo/North Central Cancer Treatment Group study
AU - Donohue, J. H.
AU - Williams, S.
AU - Cha, S.
AU - Windschitl, H. E.
AU - Witzig, Thomas Elmer
AU - Nelson, Heidi
AU - Fitzgibbons, R. J.
AU - Wieand, H. S.
AU - Moertel, C. G.
PY - 1995
Y1 - 1995
N2 - Purpose: To evaluate the effect of perioperative blood transfusions on colorectal cancer recurrence and patient survival. Patients and Methods: A total of 1,051 patients treated with curative surgery for stage II or III colorectal adenocarcinoma were retrospectively studied for the effect of perioperative blood transfusions on disease recurrence and patient survival. Forty-two percent of patients received perioperative blood components. Results: Perioperative transfusions had no effect on disease progression in univariate or multivariate analysis. Tumor stage (P = .0001), locally advanced tumor characteristics (adherence, involvement of adjacent structure, or perforation; P = .0001), location (rectal v colon; P = .0002), grade (P < .001), and cell kinetic profile (nondiploid or high percent synthetic phase [%S] + percent gap 2 mitosis phase [%G2M]; P = .0003) were the most powerful independent predictors of tumor recurrence. Use of transfusions was associated with an adverse effect on overall survival (P < .004) using multivariate analysis, as well as tumor stage (P = .0001), location(P = .004), grade (P = .001), patient age (P = .0001), sex (P < .04), and cell kinetic profile (P = .0001). In further evaluation of the prognostic effects of transfusions, there was no increased risk of disease recurrence after whole-blood transfusions (P = .14) as compared with packed RBC or no transfusions, although the disease-specific survival for patients who received whole blood was lower than for nontransfused patients (P < .005) and patients who received other blood components (P < .03). Conclusion: With transfusion practices that use blood components, most commonly RBCs, medically indicated transfusions to patients with colorectal carcinoma seem to have no impact on disease recurrence. The adverse impact of transfusions on cancer patient survival is more likely due to ether unevaluated tumor variables or underlying illness rather than tumor recurrence enhancement by immunosuppression induced by transfusion of blood components.
AB - Purpose: To evaluate the effect of perioperative blood transfusions on colorectal cancer recurrence and patient survival. Patients and Methods: A total of 1,051 patients treated with curative surgery for stage II or III colorectal adenocarcinoma were retrospectively studied for the effect of perioperative blood transfusions on disease recurrence and patient survival. Forty-two percent of patients received perioperative blood components. Results: Perioperative transfusions had no effect on disease progression in univariate or multivariate analysis. Tumor stage (P = .0001), locally advanced tumor characteristics (adherence, involvement of adjacent structure, or perforation; P = .0001), location (rectal v colon; P = .0002), grade (P < .001), and cell kinetic profile (nondiploid or high percent synthetic phase [%S] + percent gap 2 mitosis phase [%G2M]; P = .0003) were the most powerful independent predictors of tumor recurrence. Use of transfusions was associated with an adverse effect on overall survival (P < .004) using multivariate analysis, as well as tumor stage (P = .0001), location(P = .004), grade (P = .001), patient age (P = .0001), sex (P < .04), and cell kinetic profile (P = .0001). In further evaluation of the prognostic effects of transfusions, there was no increased risk of disease recurrence after whole-blood transfusions (P = .14) as compared with packed RBC or no transfusions, although the disease-specific survival for patients who received whole blood was lower than for nontransfused patients (P < .005) and patients who received other blood components (P < .03). Conclusion: With transfusion practices that use blood components, most commonly RBCs, medically indicated transfusions to patients with colorectal carcinoma seem to have no impact on disease recurrence. The adverse impact of transfusions on cancer patient survival is more likely due to ether unevaluated tumor variables or underlying illness rather than tumor recurrence enhancement by immunosuppression induced by transfusion of blood components.
UR - http://www.scopus.com/inward/record.url?scp=0029025150&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0029025150&partnerID=8YFLogxK
M3 - Article
C2 - 7602357
AN - SCOPUS:0029025150
VL - 13
SP - 1671
EP - 1678
JO - Journal of Clinical Oncology
JF - Journal of Clinical Oncology
SN - 0732-183X
IS - 7
ER -