Abstract
The effect of perioperative blood transfusions on survival after curative resection for colorectal carcinoma was studied retrospectively on 270 patients with special emphasis on whole blood transfusion. Eightysix (32 percent) patients did not receive blood transfusions, whereas the remaining 110 (41 percent) received packed cells and 74 (27 percent) received at least 2 units of whole blood. The recurrence-free and overall 5-year survival rates for the transfused group were 58 and 57 percent, respectively, and for the non-transfused group, 78 and 72 percent, respectively. These differences were highly significant (log rank test,P<0.001). The recurrence-free and overall 5-year survival rates for patients who received only whole blood or a combination of whole blood and packed cells was 51 percent, and of those who received only packed cells was 63 percent. The difference was not statistically significant (log rank test,P=0.08,P=0.35). Administration of more than 6 units of blood is attended with a significantly worse 5-year disease-free survival rate than administration of a smaller volume. The survival was not decreased if 6 or more units of whole blood were given. The authors conclude that perioperative blood transfusions have a significant detrimental effect on survival after curative resection for colorectal carcinoma. This effect is not enhanced by whole blood transfusions.
Article PDF
Similar content being viewed by others
Avoid common mistakes on your manuscript.
References
Burrows L, Tartter P. Effects of blood transfusions on colonic malignancy recurrence rate. Lancet 1982;2:662.
Opelz G, Terasaki PI. Improvement of kidney-graft survival with increased numbers of blood transfusions. N Engl J Med 1978;299:799–803.
Blumberg N, Agarwal MM, Chuang C. Relation between recurrence of cancer of the colon and blood transfusion. Br Med J 1985;290:1037–9.
Blumberg N, Heal JM, Murphy P, Agarwal MM, Chuang C. Association between transfusion of whole blood and recurrence of cancer. Br Med J 1986;293:530–3.
Cox DR. Regression models and life tables. J R Stat Soc (B) 1972;34:187–202.
Kaplan E, Meier P. Nonparametric estimation from incomplete observations. J Am Stat Assoc 1958;53:457–81.
George CD, Morello PJ. Immunologic effects of blood transfusions upon renal transplantation, tumor operations, and bacterial infections. Am J Surg 1986;152:329–37.
Francis DM, Judson RT. Blood transfusion and recurrence of cancer of the colon and rectum. Br J Surg 1987;74:26–30.
Horimi T, Kagawa S, Ninomiva M, Yoshida E, Hiramatsu S, Onita K. Possible induction by transfusions of immunological tolerance against growth of transplanted tumours in mice. Acta Med Okayama 1983;37:259–63.
Singh SK, Marquet RL, Westbroek DL, Jeekel J. Enhanced growth of artificial tumor metastases following blood transfusion: the effect of erythrocytes, leukocytes, and plasma transfusion. Eur J Cancer Clin Oncol 1987;23:1537–40.
Voogt PJ, van de Velde CJH, Brand A, et al. Perioperative blood transfusions and cancer prognosis: different effects of blood transfusion on prognosis of colon and breast cancer patients. Cancer 1987;59:836–43.
Persijn GG, Cohen B, Lansbergen O, van Rood JJ. Retrospective and prospective studies on the effect of blood transfusions in renal transplantation in the Netherlands. Transplantation 1979;28:396–401.
Foster RS Jr, Costanza MC, Foster JC, Wanner MC, Foster CB. Adverse relationship between blood transfusions and survival after colectomy for colon cancer. Cancer 1985;55:1195–1201.
Corman J, Arnoux R, Péloquin A, St. Louis G, Smeesters C, Giroux L. Blood transfusions and survival after colectomy for colorectal cancer. Can J Surg 1986;29:325–9.
Freedman LS. Tables of the number of patients required in clinical trials using the log rank test. Stat Med 1982;1:121–9.
Spratt JS. Blood transfusions and surgery for cancer. Am J Surg 1986;152:337.
Author information
Authors and Affiliations
Additional information
Reprints will not be available.
About this article
Cite this article
Wobbes, T., Joosen, K.H.G., Kuypers, H.H.C. et al. The effect of packed cells and whole blood transfusions on survival after curative resection for colorectal carcinoma. Dis Colon Rectum 32, 743–748 (1989). https://doi.org/10.1007/BF02562121
Issue Date:
DOI: https://doi.org/10.1007/BF02562121