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