Association between blood transfusion and survival in a randomised multicentre trial of perioperative adjuvant portal chemotherapy in patients with colorectal cancer. The Swiss Group for Clinical Cancer Research (SAKK).
OBJECTIVE
To assess the prognosis associated with blood transfusion alone and in combination with adjuvant perioperative chemotherapy in patients with colorectal cancer.


METHODS
Univariate and multivariate retrospective analyses of survival associated with blood transfusion in patients who had taken part in a randomised multicentre trial (SAKK 40/81).


METHODS
Swiss Group for Clinical Cancer Research (SAKK).


METHODS
450 patients, 104 of whom (23%) did not have a blood transfusion and 346 of whom (77%) did.


METHODS
Resection of colorectal cancer and portal infusion of adjuvant chemotherapy.


METHODS
Disease-free and overall survival.


RESULTS
The median follow-up was 9 years, and patients who had received transfusions had significantly shorter disease-free survival time (hazard ratio (HR) = 1.60; 95% CI 1.12 to 2.38). The transfusion of more than 4 units of blood products was associated with a significantly higher risk (HR = 2.52; 95% CI 1.43 to 4.44). Patients who had no transfusion and who had been assigned to have portal infusion of chemotherapy had a significantly longer disease-free survival time than patients who had transfusion but no chemotherapy (HR = 0.38; 95% CI 0.19 to 0.77).


CONCLUSIONS
There was an adverse association between blood transfusion and disease-free survival. Patients given perioperative intraportal chemotherapy but no transfusion had the best disease-free survival. We recommend restricting the use of blood transfusions in patients with colorectal cancer.
D000368:Aged; D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage / Q000627:therapeutic use*; D001803:Blood Transfusion; D017024:Chemotherapy, Adjuvant; D003110:Colonic Neoplasms / Q000188:drug therapy* / Q000401:mortality* / Q000601:surgery; D018572:Disease-Free Survival; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D015999:Multivariate Analysis; D011169:Portal Vein; D011379:Prognosis; D012004:Rectal Neoplasms / Q000188:drug therapy* / Q000401:mortality* / Q000601:surgery; D016019:Survival Analysis
D000964:Antimetabolites, Antineoplastic; D005472:Fluorouracil