Blood Transfusions and Prognosis in Colorectal Cancer

作者：Olivier R. Busch, Wim C.J. Hop, M A Hoynck van Papendrecht, Richard L. Marquet, Johannes J. Jeekel · 发表于：New England Journal of Medicine · 年份：1993 · DOI：10.1056/nejm199305133281902 · 被引用次数：557 · 研究领域：Blood transfusion and management、Cancer, Hypoxia, and Metabolism、Erythropoietin and Anemia Treatment

BACKGROUND: Blood transfusions may adversely affect the prognosis of patients treated surgically for cancer, although definite proof of this adverse effect has not been reported. METHODS: We carried out a randomized trial to investigate whether the prognosis in patients with colorectal cancer would be improved by a program of autologous blood transfusion as compared with the current practice of allogeneic transfusion. Patients in the autologous-transfusion group were required to donate two units of blood before surgery. RESULTS: A total of 475 patients were evaluated. We found no significant difference in prognosis between the allogeneic-transfusion group (236 patients) and the autologous-transfusion group (239 patients); colorectal cancer-specific survival rates at four years were 67 percent and 62 percent, respectively (P = 0.39). Among the 423 patients who underwent curative surgery, 66 percent of those in the allogeneic-transfusion group and 63 percent of those in the autologous-transfusion group had no recurrence of colorectal cancer at four years (P = 0.93). We also found that the risk of recurrence was significantly increased in patients who received blood transfusions, either allogeneic or autologous, as compared with patients who did not require transfusions; the relative rates of recurrence were 2.1 (P = 0.01) and 1.8 (P = 0.04), respectively; these rates did not differ significantly from each other. CONCLUSIONS: The use of autologous blood as compared with allogene...