Blood Transfusion Does Not Adversely Affect Survival After Elective Colon Cancer Resection: a Propensity Score Analysis

Overview

Journal Langenbecks Arch Surg

Specialty General Surgery

Date 2013 Jul 11

PMID 23838797

Citations 10

Authors

Ignazio Tarantino

Kristjan Ukegjini

Rene Warschkow

Bruno M Schmied

Thomas Steffen

Alexis Ulrich

Sascha A Muller

Affiliations

Soon will be listed here.

Abstract

Purpose: The aim of this study was to assess the putative impact of perioperative blood transfusions on overall survival in patients undergoing curative resection for stage III colon cancer by applying propensity scoring methods.

Methods: In a single-center study, a total of 309 patients who underwent open curative resection for stages I-III colon cancer from 1996-2008 were assessed. The mean follow-up period was 47 ± 38 months. Transfused and non-transfused patients were compared using both Cox regression and propensity score analyses.

Results: Overall, 148 patients (47.9 %) received blood transfusions. The patient characteristics were highly biased toward transfusions (propensity score 0.68 ± 0.22 vs. 0.30 ± 0.22, p <0.001). In the unadjusted analysis, blood transfusions were associated with a 90 % increased risk of overall mortality (hazard ratio 1.90, 95 % CI: 1.19-3.04, p = 0.001). The 5-year survival for patients receiving blood transfusions was 64.5 % (95 % CI: 56.0-74.3 %) compared with 80.1 % (95 % CI: 72.8-88.2 %) in those not receiving blood transfusions. In the propensity score-adjusted Cox regression analysis (hazard ratio: 0.85, 95 % CI = 0.53-1.37, p = 0.501), blood transfusions did not increase the risk of overall mortality. After risk adjustment, the 5-year survival rate for patients receiving blood transfusions was 66.6 % (95 % CI: 57.4-77.3 %) compared with 61.8 % (95 % CI: 51.9-73.7 %) for those who did not.

Conclusion: This study is the first propensity score-based analysis that provides evidence that poor oncological outcomes after curative colon cancer resection in patients receiving perioperative blood transfusions are due to the clinical circumstances that require the transfusions and are not due to the blood transfusions.

Citing Articles

The association of perioperative blood transfusion with survival outcomes after major cancer surgery: a population-based cohort study in South Korea.

Kim S, Song I, Oh T Surg Today. 2024; 54(7):712-721.

PMID: 38175292 DOI: 10.1007/s00595-023-02783-w.

Association of perioperative allogeneic blood transfusions and long-term outcomes following radical surgery for gastric and colorectal cancers: systematic review and meta-analysis of propensity-adjusted observational studies.

Zhang W, Xu H, Huang B, Xu Y, Huang J BJS Open. 2023; 7(4).

PMID: 37584435 PMC: 10428665. DOI: 10.1093/bjsopen/zrad075.

Effect of a Patient Blood Management system on perioperative transfusion practice and short-term outcomes of colorectal cancer surgery.

Shin S, Piozzi G, Kwak J, Baek S, Kim J, Kim S Blood Transfus. 2022; 20(6):475-482.

PMID: 35848631 PMC: 9726617. DOI: 10.2450/2022.0328-21.

Do Preoperative Transfusions Impact Prognosis in Moderate to Severe Anaemic Surgical Patients with Colon Cancer?.

Tamini N, Gianotti L, Darwish S, Petitto S, Bernasconi D, Oldani M Curr Oncol. 2021; 28(6):4634-4644.

PMID: 34898556 PMC: 8628678. DOI: 10.3390/curroncol28060391.

Red blood cell transfusions and the survival in patients with cancer undergoing curative surgery: a systematic review and meta-analysis.

Petrelli F, Ghidini M, Ghidini A, Sgroi G, Vavassori I, Petro D Surg Today. 2021; 51(10):1535-1557.

PMID: 33389174 DOI: 10.1007/s00595-020-02192-3.

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