Leucocyte depletion of perioperative blood transfusion does not affect long-term survival and recurrence in patients with gastrointestinal cancer.
BACKGROUND
Perioperative red blood cell (RBC) transfusion may be associated with a poor prognosis in cancer surgery. Allogeneic leucocytes are assumed to play a causal role. This study evaluated the long-term effect of transfusion with leucocyte-depleted (LD) blood in patients with gastrointestinal cancer.


METHODS
The Transfusion Associated Complications = Transfusion Induced Complications? (TACTIC) study is a multicentre randomized controlled trial evaluating the short-term benefits of LD versus non-LD RBC transfusions. The present study evaluated 5-year survival and cancer recurrence among 512 patients with gastrointestinal cancer included in the TACTIC study.


RESULTS
Some 89.2 per cent of patients had a primary tumour and 79.7 per cent underwent surgery with curative intent; 243 patients received perioperative RBC transfusion (median 3 units). The 5-year overall survival rate of patients with any type of gastrointestinal cancer was 50.8 per cent in the LD group and 45.8 per cent in the non-LD group (P = 0.191). Corresponding 5-year disease-free survival rates were 60.0 and 56.6 per cent (P = 0.482), and recurrence rates 32.9 and 34.3 per cent (P = 0.864).


CONCLUSIONS
Leucocyte depletion is not associated with better long-term survival and lower recurrence rates in patients with gastrointestinal cancer.
Lange
M M
MM
Department of Surgery, Leiden University Medical Centre, Leiden, The Netherlands.
van Hilten
J A
JA
van de Watering
L M G
LM
Bijnen
B A
BA
Roumen
R M H
RM
Putter
H
H
Brand
A
A
van de Velde
C J H
CJ
D000368:Aged; D001803:Blood Transfusion / Q000379:methods* / Q000401:mortality; D018572:Disease-Free Survival; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000401:mortality / Q000628:therapy*; D006801:Humans; D007430:Intraoperative Care / Q000401:mortality; D007937:Leukapheresis / Q000379:methods*; D007962:Leukocytes; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000517:prevention & control*; D011379:Prognosis; D065227:Transfusion Reaction