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<.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<.001). Recurrence in patients transfused only during surgery (N=201) was higher than in nontransfused patients (P<.001) and, similarly, all patients transfused during surgery (N=297) had an increased risk (P<.001). Among patients with rectal cancer, transfusion increased the risk of recurrence in those treated by abdominoperineal resection (P<.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 (Χ²=54.04, df=6, P<.0001 and Χ²=13.93, df=3, P<.003). The risk of recurrence following curative surgery for colorectal cancer is markedly increased by blood transfusion on the day of operation.