Chiarugi M, Buccianti P, Disarli M, Galatioto C, Cavina E
University of Pisa Medical School, Department of Surgery, Santa Chiara Hospital, Pisa, Italy.
Hepatogastroenterology. 2000 Jul-Aug;47(34):1002-5.
BACKGROUND/AIMS: To assess retrospectively the impact of perioperative blood transfusions on disease-free interval after curative surgery of rectal cancer.
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.
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).
This study suggests that blood transfusion is likely to have a detrimental effect on disease-free interval after resective surgery of rectal cancer.
背景/目的:回顾性评估围手术期输血对直肠癌根治性手术后无病生存期的影响。
1990年至1996年间,107例患者(65例男性,42例女性,中位年龄:67岁)因直肠癌接受直肠前切除术。36例(37%)患者围手术期接受输血。测量的结果变量包括:年龄、性别、肿瘤距肛缘的距离、吻合器吻合类型、保护性结肠造口术、标本切缘、分级和分期、缝合线渗漏、输血、输血单位数量及辅助治疗。
单因素分析显示,输血、淋巴结受累及辅助治疗对无病生存期有显著影响。未输血患者5年无癌生存率估计为81%,输血患者为63%(P<0.05)。多因素分析显示,淋巴结受累与复发时间显著且独立相关(P<0.05),但围手术期输血也显示出作为直肠癌复发独立危险因素的重要作用(P=0.05)。
本研究提示,输血可能对直肠癌切除术后的无病生存期产生不利影响。