Association between blood transfusion and survival in a randomised multicentre trial of perioperative adjuvant portal chemotherapy in patients with colorectal cancer. The Swiss Group for Clinical Cancer Research (SAKK).

Abstract

OBJECTIVE:

To assess the prognosis associated with blood transfusion alone and in combination with adjuvant perioperative chemotherapy in patients with colorectal cancer.

DESIGN:

Univariate and multivariate retrospective analyses of survival associated with blood transfusion in patients who had taken part in a randomised multicentre trial (SAKK 40/81).

SETTING:

Swiss Group for Clinical Cancer Research (SAKK).

SUBJECTS:

450 patients, 104 of whom (23%) did not have a blood transfusion and 346 of whom (77%) did.

INTERVENTIONS:

Resection of colorectal cancer and portal infusion of adjuvant chemotherapy.

MAIN OUTCOME MEASURES:

Disease-free and overall survival.

RESULTS:

The median follow-up was 9 years, and patients who had received transfusions had significantly shorter disease-free survival time (hazard ratio (HR) = 1.60; 95% CI 1.12 to 2.38). The transfusion of more than 4 units of blood products was associated with a significantly higher risk (HR = 2.52; 95% CI 1.43 to 4.44). Patients who had no transfusion and who had been assigned to have portal infusion of chemotherapy had a significantly longer disease-free survival time than patients who had transfusion but no chemotherapy (HR = 0.38; 95% CI 0.19 to 0.77).

CONCLUSIONS:

There was an adverse association between blood transfusion and disease-free survival. Patients given perioperative intraportal chemotherapy but no transfusion had the best disease-free survival. We recommend restricting the use of blood transfusions in patients with colorectal cancer.

• Journal: The European journal of surgery = Acta chirurgica (Eur J Surg) Vol. 163 Issue 9 Pg. 693-701 (Sep 1997) ISSN: 1102-4151 [Print] England
• PMID: 9311477 (Publication Type: Clinical Trial, Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Antimetabolites, Antineoplastic
• Fluorouracil

Topics

• Aged
• Antimetabolites, Antineoplastic (administration & dosage, therapeutic use)
• Blood Transfusion
• Chemotherapy, Adjuvant
• Colonic Neoplasms (drug therapy, mortality, surgery)
• Disease-Free Survival
• Female
• Fluorouracil (administration & dosage, therapeutic use)
• Humans
• Infusions, Intravenous
• Male
• Multivariate Analysis
• Portal Vein
• Prognosis
• Rectal Neoplasms (drug therapy, mortality, surgery)
• Survival Analysis