Faculty of Medicine, University Medical Centre Bezanijska kosa, University of Belgrade, Belgrade, Serbia.
Med Oncol. 2011 Mar;28(1):170-4. doi: 10.1007/s12032-010-9441-3. Epub 2010 Feb 12.
The aim of this study is to evaluate influence of allogeneic blood transfusion on prognosis in patients in Dukes B stage of colorectal cancer. All patients with colorectal cancer who were admitted at our Department of Surgery between January 2000 and December 2004 were analyzed. One hundred fifty-one patients who fulfilled inclusion criteria were enrolled in further evaluation. B stage according to Dukes classification and curative resection were inclusion criteria. Exclusion criteria were polyposis syndromes, nonpolyposis syndromes, inflammatory bowel disease, autoimmune disease and previous blood transfusion. Patients were divided into two groups: Group 1 received ≤ 3 units of allogeneic blood transfusion and group 2 received >3 units of allogeneic blood transfusion. "Cutoff" value of 3 units of blood was defined according to our results and literature data. Follow-up was 5 year. There was no statistical difference between these groups in local recurrence (χ(2) = 0.009, P > 0.05) and distant metastasis (χ(2) = 0.44, P > 0.05). Also, the Kaplan-Meier survival curves were calculated, and long-rank test did not show a survival difference between these two groups (log rank = 0.075, P > 0.05). Postoperative complications are significantly more frequent in Group 2 (χ(2) = 4.67, P < 0.05). Multivariate logistic regression analysis confirmed that intraoperative blood transfusion more than three units had independent influence on local recurrence. Postoperative transfusion more than 3 units was statistically independent prognostic factor for metastasis and mortality. Overall transfusion less than 3 units of allogeneic blood does not influence the outcome of patients in Dukes B stage of colorectal cancer.
本研究旨在评估异体输血对 Dukes B 期结直肠癌患者预后的影响。分析 2000 年 1 月至 2004 年 12 月期间在我外科接受治疗的所有结直肠癌患者。符合纳入标准的 151 例患者被纳入进一步评估。纳入标准为 Dukes 分期 B 期和根治性切除术。排除标准为息肉综合征、非息肉综合征、炎症性肠病、自身免疫性疾病和既往输血。患者分为两组:组 1 接受≤3 单位异体输血,组 2 接受>3 单位异体输血。根据我们的结果和文献数据,将 3 个单位的血液定义为“临界值”。随访 5 年。两组局部复发(χ(2) = 0.009,P > 0.05)和远处转移(χ(2) = 0.44,P > 0.05)差异无统计学意义。此外,计算了 Kaplan-Meier 生存曲线,等级相关检验未显示两组之间的生存差异(对数秩=0.075,P > 0.05)。组 2 术后并发症明显更常见(χ(2) = 4.67,P < 0.05)。多因素逻辑回归分析证实,术中输血超过 3 个单位对局部复发有独立影响。术后输血超过 3 个单位是远处转移和死亡的独立预后因素。总体而言,少于 3 个单位的异体输血不会影响 Dukes B 期结直肠癌患者的预后。