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)
European Journal of Surgery 163(9): 693-701
1997
ISSN/ISBN: 1102-4151 PMID: 9311477 Document Number: 471654
To assess the prognosis associated with blood transfusion alone and in combination with adjuvant perioperative chemotherapy in patients with colorectal cancer. 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). Swiss Group for Clinical Cancer Research (SAKK). 450 patients, 104 of whom (23%) did not have a blood transfusion and 346 of whom (77%) did. Resection of colorectal cancer and portal infusion of adjuvant chemotherapy. Disease-free and overall survival. 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). 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.