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News

Increased blood transfusions reduce rectal cancer surgery survival

Increased numbers of blood units are associated with postoperative mortality in patients undergoing rectal cancer surgery, reports August's Diseases of the Colon and Rectum.

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The number of perioperative blood units is associated with postoperative mortality and overall survival.

In addition, allogenic perioperative blood transfusion has been postulated to produce host immunosuppression.

It has been reported to result in adverse outcome in patients with colorectal cancer.

Autologous blood transfusion might improve results compared with allogenic transfusion.

Dr Michael Jagoditsch and colleagues from Austria determined whether type or number of blood units transfused affected short-term and long-term outcomes with rectal cancer surgery.

The team analyzed clinical outcome for 597 patients undergoing surgery for rectal cancer according to their transfusion status.

Postoperative mortality was 6% with 3 units vs 1% for 1 unit of blood
Diseases of the Colon & Rectum

Results for type and number of blood units transfused were recorded.

The researchers found that blood transfusion was associated with increased postoperative mortality at 60 days.

Patients who received 3 units or more had a postoperative mortality of 6% compared with 1% for patients who received 1 to 3 units and 0% for patients who did not require transfusions.

The research team observed no difference between patients who received autologous or allogenic blood.

Blood transfusions were also associated with impaired overall survival in a univariate analysis.

However, the team noted that this was not confirmed in the multivariate analysis.

The number or type of blood units transfused did not influence oncologic results.

The researchers identified local recurrence rates, distant metastases rates, and disease-free survival as not being influenced by transfusion in these patients.

Dr Jagoditsch's team concludes, “Increased numbers of blood units were associated with postoperative mortality.”

“However, there is no reason, with respect to cancer recurrence or disease-free survival, to use a program of transfusion with autologous blood in patients undergoing surgery for rectal cancer.”

Dis Col Rectum 2006: 49(8): 1116-130
18 August 2006

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