Transfusions associated with CRC recurrence and worse OS

  • Wu HL & al.
  • Sci Rep
  • 6 Sep 2018

  • curated by Kelli Whitlock Burton
  • Univadis Clinical Summaries
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Takeaway

  • Perioperative blood transfusions are associated with significantly higher risk for recurrence and worse OS in patients with colorectal cancer (CRC), regardless of preoperative anemia status.

Why this matters

  • Although animal studies have suggested a link between blood transfusions and poor outcomes in cancer, human studies have yielded conflicting results.

Study design

  • 4030 patients with stage I-III CRC underwent resection.
  • Funding: Taipei Veterans General Hospital and Ministry of Science and Technology, Taipei, Taiwan.

Key results

  • Patients who received a blood transfusion had a higher risk for cancer recurrence (HR, 1.41; 95% CI, 1.2-1.66) and higher risk for all-cause mortality (HR, 1.97; 95% CI, 1.6-2.43), independent of anemia status before surgery.
  • After multivariable analysis, there was a significantly higher risk for cancer recurrence in the transfusion group (HR, 1.38; 95% CI, 1.02-1.87).
  • After propensity matching, perioperative blood transfusion remained a significant mortality risk factor (HR, 2.00; 95% CI, 1.27-3.15).
  • There was a significant association between transfusion volume and overall mortality risk (≤4 units vs 0: HR, 1.58 [P=.001]; >4 units vs 0: HR, 2.32 [P<.001>4 units vs ≤4 units: aHR, 1.46 [P=.012]), but not in cancer recurrence.

Limitations

  • Single-center, retrospective study.

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