DOI QR코드

DOI QR Code

Effects of Allogeneic Blood Transfusion in Patients with Stage II Colon Cancer

  • Meng, Jin (Department of Gastrointestinal Surgery, The Fourth Affiliated Hospital, China Medical University) ;
  • Lu, Xiao-Bo (Department of Toxicology, Public Health School, China Medical University) ;
  • Tang, Yuan-Xin (Department of Gastrointestinal Surgery, The Fourth Affiliated Hospital, China Medical University) ;
  • Sun, Gong-Ping (Department of Gastrointestinal Surgery, The Fourth Affiliated Hospital, China Medical University) ;
  • Li, Xin (Department of Gastrointestinal Surgery, The Fourth Affiliated Hospital, China Medical University) ;
  • Yan, Yi-Fei (Department of Gastrointestinal Surgery, The Fourth Affiliated Hospital, China Medical University) ;
  • Liang, Gao-Feng (Department of Gastrointestinal Surgery, The Fourth Affiliated Hospital, China Medical University) ;
  • Ma, Si-Ping (Department of Colorectal Surgery, Liaoning Province Tumor Hospital) ;
  • Li, Xiao-Xia (Department of Gastrointestinal Surgery, The Fourth Affiliated Hospital, China Medical University)
  • Published : 2013.01.31

Abstract

The aim of the present study was to determine whether allogeneic red blood cell transfusions showed a deleterious effect and what might be preoperative risk factors for blood transfusion in patients with TNM stage II colon cancer. Total 470 patients who fulfilled inclusion criteria were selected for a further 10-year follow-up study. We found that there were statistical significance between non-transfused and transfused group in mortality (P=0.018), local recurrence (P=0.000) and distant metastasis (P=0.040). Local recurrence and distant metastasis between 1 to 3 units and more than 3 units group did not show any significant differences. There was no difference in survival rate between non-transfused and 1 to 3 units group (log rank=0.031, P=0.860). The difference between different blood transfusion volume in transfused patients was found (78.77% vs 63.83%, P=0.006). Meanwhile, the significant difference of survival rate was existed between non-transfused group and more than 3 units group (84.83% vs 63.83%, P=0.002 ). Univariate analysis showed the following 3 variables to be associated with an increased risk of allogeneic blood transfusions: preoperative CEA level (P<0.05), location of tumor (P<0.01) and diameter of tumor (P<0.01). Multivariate analysis revealed that location of tumor and diameter of tumor are two independent factors for requirement of perioperative transfusions. Therefore, allogeneic transfusion increase the postoperative tumor mortality, local recurrence and distant metastasis in patients with stage II colon cancer. The postoperative tumor mortality, local recurrence and distant metastasis were not associated with the blood transfusion volume. The blood transfusion volume was associated with the survival rate. Location of tumor and diameter of tumor were the independent preoperative risk factors for blood transfusion.

Keywords

References

  1. Aghili M, Izadi S, Madani H, et al (2010). Clinical and pathological evaluation of patients with early and late recurrence of colorectal cancer. Asia Pac J Clin Oncol, 6, 35-41. https://doi.org/10.1111/j.1743-7563.2010.01275.x
  2. Amato A, Pescatori M (2006). Perioperative blood transfusions for the recurrence of colorectal cancer. Cochrane Database Syst Rev, 25, CD005033.
  3. Bordin JO, Chiba AK, Carvalho KI, et al (1999). The effect of unmodified or prestorage white cell-reduced allogeneic red cell transfusions on the immune responsiveness in orthopedic surgery patients. Transfusion, 39, 718-23. https://doi.org/10.1046/j.1537-2995.1999.39070718.x
  4. Busch OR, Hop WC, Marquet RL, et al (1994). Blood transfusions and local tumor recurrence in colorectal cancer. Evidence of a noncausal relationship. Ann Surg, 220, 791-7. https://doi.org/10.1097/00000658-199412000-00013
  5. Center MM, Jemal A, Smith RA, et al (2009). Worldwide variations in colorectal cancer. CA Cancer J Clin, 59, 366-78. https://doi.org/10.3322/caac.20038
  6. Chung M, Steinmetz OK, Gordon PH (1993). Perioperative blood transfusion and outcome after resection for colorectal carcinoma. Br J Surg, 80, 427-32. https://doi.org/10.1002/bjs.1800800407
  7. Compton CC, Fielding LP, Burgart LJ, et al (2000). Prognostic factors in colorectal cancer. College of American Pathologists Consensus Statement 1999. Arch Pathol Lab Med, 124, 979-94.
  8. Gantt CL (1981). Red blood cells for cancer patients. Lancet, 12, 363.
  9. Gascon P, Zoumbos NC, Young NS (1984). Immunologic abnormalities in patients receiving multiple blood transfusions. Ann Intern Med, 100, 173-7. https://doi.org/10.7326/0003-4819-100-2-173
  10. Ghio M, Contini P, Mazzei C, et al (1999). Soluble HLA class I, HLA class II, and Fas ligand in blood components: a possible key to explain the immunomodulatory effects of allogeneic blood transfusions. Blood, 93, 1770-7.
  11. Ikuta S, Miki C, Hatada T, et al (2003). Allogenic blood transfusion is an independent risk factor for infective complications after less invasive gastrointestinal surgery. Am J Surg, 185, 188-93. https://doi.org/10.1016/S0002-9610(02)01370-3
  12. Kaplan J, Sarnaik S, Gitlin J, et al (1984). Diminished helper/ suppressor lymphocyte ratios and natural killer activity in recipients of repeated blood transfusions. Blood, 64, 308-10.
  13. Kobayashi H, Mochizuki H, Sugihara K, et al (2007). Characteristics of recurrence and surveillance tools after curative resection for colorectal cancer: a multicenter study. Surgery, 14, 167-75.
  14. Peters WR, Fry RD, Fleshman JW, et al (1989). Multiple blood transfusions reduce the recurrence rate of Crohn's disease. Dis Colon Rectum, 32, 749-53. https://doi.org/10.1007/BF02562122
  15. Vamvakas EC (1995). Perioperative blood transfusion and cancer recurrence: meta-analysis for explanation. Transfusion, 35, 760-8. https://doi.org/10.1046/j.1537-2995.1995.35996029162.x
  16. van der Voort van Zijp J, Hoekstra HJ, Basson MD (2008). Evolving management of colorectal cancer. World J Gastroenterol, 14, 3956-67. https://doi.org/10.3748/wjg.14.3956
  17. Voogt PJ, van de Velde CJ, Brand A, et al (1987). Perioperative blood transfusion and cancer prognosis. Different effects of blood transfusion on prognosis of colon and breast cancer patients. Cancer, 59, 836-43. https://doi.org/10.1002/1097-0142(19870215)59:4<836::AID-CNCR2820590430>3.0.CO;2-S
  18. Weiden PL, Bean MA, Schultz P (1987). Perioperative blood transfusion does not increase the risk of colorectal cancer recurrence. Cancer, 60, 870-4. https://doi.org/10.1002/1097-0142(19870815)60:4<870::AID-CNCR2820600425>3.0.CO;2-0
  19. Ydy LR, Slhessarenko N, de Aguilar-Nascimento JE (2007). Effect of perioperative allogeneic red blood cell transfusion on the immune -inflammatory response after colorectal cancer resection. World J Surg, 31, 2044-51. https://doi.org/10.1007/s00268-007-9159-3
  20. Zdravkovic D, Bilanovic D, Randjelovic T, et al (2011). Allogeneic blood transfusion in patients in Dukes B stage of colorectal cancer. Med Oncol, 28, 170-4. https://doi.org/10.1007/s12032-010-9441-3

Cited by

  1. Impact of Allogenic and Autologous Transfusion on Immune Function in Patients with Tumors vol.15, pp.1, 2014, https://doi.org/10.7314/APJCP.2014.15.1.467
  2. Use of Blood Transfusion at the End of Life: Does it Have Any Effects on Survival of Cancer Patients? vol.15, pp.10, 2014, https://doi.org/10.7314/APJCP.2014.15.10.4251
  3. Influence of Autologous and Homologous Blood Transfusion on Interleukins and Tumor Necrosis Factor-α in Peri-operative Patients with Esophageal Cancer vol.15, pp.18, 2014, https://doi.org/10.7314/APJCP.2014.15.18.7831
  4. Clinical Practice of Blood Transfusion in Orthotopic Organ Transplantation: A Single Institution Experience vol.16, pp.17, 2015, https://doi.org/10.7314/APJCP.2015.16.17.8009
  5. Adjuvant Chemotherapy and Prognostic Factors in Stage II Colon Cancer - Izmir Oncology Group Study vol.16, pp.6, 2015, https://doi.org/10.7314/APJCP.2015.16.6.2413
  6. Perioperative Blood Transfusion and Postoperative Outcome in Patients with Crohn’s Disease Undergoing Primary Ileocolonic Resection in the “Biological Era” vol.19, pp.10, 2015, https://doi.org/10.1007/s11605-015-2893-1
  7. Impact of Peri-Operative Anemia and Blood Transfusions in Patients with Gastric Cancer Receiving Gastrectomy vol.17, pp.3, 2016, https://doi.org/10.7314/APJCP.2016.17.3.1427
  8. Laparoscopic Versus Open Liver Resection for Colorectal Liver Metastases: A Comprehensive Systematic Review and Meta-analysis vol.7, pp.1, 2017, https://doi.org/10.1038/s41598-017-00978-z
  9. Immunomodulatory Effects of Blood Transfusion on Tumor Size, Metastasis, and Survival in Experimental Fibrosarcoma vol.34, pp.4, 2018, https://doi.org/10.1007/s12288-018-0962-9
  10. Perioperative transfusion and the prognosis of colorectal cancer surgery: a systematic review and meta-analysis vol.17, pp.1, 2019, https://doi.org/10.1186/s12957-018-1551-y