Effect of blood transfusions on disease-free interval after rectal cancer surgery.
OBJECTIVE
To assess retrospectively the impact of perioperative blood transfusions on disease-free interval after curative surgery of rectal cancer.


METHODS
One hundred and seven (107) subjects (65 men and 42 women, median age: 67) underwent anterior resection of the rectum for rectal cancer between 1990 and 1996. Thirty-six (37%) were transfused perioperatively. Outcome variables measured were: age, sex, distance of the tumor from the anal verge, type of stapled anastomosis, protective colostomy, cancer-free margin in the specimen, grading and staging, leak of the suture line, transfusion, number of blood units given, and adjuvant therapy.


RESULTS
Transfusion, nodes involvement and adjuvant therapy had a significant impact on disease-free interval at the univariate analysis. The estimated probability of cancer-free survival at 5 years was 81% for the not transfused, and 63% for the transfused patients (P < 0.05). At multivariate analysis, nodes involvement resulted significantly and independently related to time to recurrence (P < 0.05) but also perioperative blood transfusion showed an important role as independent risk factor for rectal cancer relapse (P = 0.05).


CONCLUSIONS
This study suggests that blood transfusion is likely to have a detrimental effect on disease-free interval after resective surgery of rectal cancer.
Chiarugi
M
M
University of Pisa Medical School, Department of Surgery, Santa Chiara Hospital, Pisa, Italy. m.chiarugi@dc.med.unipi.it
Buccianti
P
P
Disarli
M
M
Galatioto
C
C
Cavina
E
E
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D011379:Prognosis; D016016:Proportional Hazards Models; D012004:Rectal Neoplasms / Q000401:mortality* / Q000601:surgery; D012189:Retrospective Studies; D012307:Risk Factors; D065227:Transfusion Reaction; D016896:Treatment Outcome