The Effect of Perioperative Transfusion on The Prognosis of Patients with

Park, Yong Lai; Han, Won Kon

Abstract

The effect of perioperative blood transfusion on the survival rate of patients of colorectal cancer was studied. From January 1990 to December 1995, 533 patients with colorectal cancer underwent surgical treatment in the department of surgery, Kangbuk Samsung Medical Center. In these patients, 430 patients with Dukes stages A, B, and C carcinoma were divided into two groups: those who received perioperative blood transfusion and those who did not. Overall survival curves were constructed using Kaplan-Meier method and the differences between curves were tested by using the log-rank test. Comparison of variables between the transfused and nontransfused groups were evaluated with the Student t test and Chi-square test with SPSS program. Two hundred and three patients (47.2%) received transfusions within the perioperative period. The transfused group included patients with tumors of more advanced stage such as Dukes C(60.1% vs. 44.5%, p< 0.05) and more rectal cancer(88.2% vs. 55.5%, p< 0.05). In the other variables such as age distribution, sex difference, histologic grade and perioperative hemoglobin level, there was no significant difference between the transfused and non-transfused group. Although the 5-year overall survival rate was significantly lower in the transfused group than non-transfused(61% vs. 74.2%, p< 0.05), subgroup analysis according to the tumor location and Dukes stage showed no statiscally significant difference in survival in each location and stage between the two groups. It is postulated that the possible adverse influence of blood transfusion on the survival of patients with colorectal cancer is linked to other prognostic features rather than to the immunologic sequelae of the transfusion itself.