Perioperative blood transfusion in cancer patients undergoing laparoscopic colorectal resection: risk factors and impact on survival

被引:23
作者
Ghinea, R. [1 ,2 ]
Greenberg, R. [3 ,4 ]
White, I. [1 ,2 ]
Sacham-Shmueli, E. [4 ,5 ]
Mahagna, H. [3 ,4 ]
Avital, S. [1 ,2 ]
机构
[1] Tel Aviv Univ, Dept Surg B, Meir Med Ctr, Kefar Sava, Israel
[2] Tel Aviv Univ, Sackler Fac Med, Kefar Sava, Israel
[3] Tel Aviv Univ, Tel Aviv Med Ctr, Dept Surg, IL-69978 Tel Aviv, Israel
[4] Tel Aviv Univ, Sackler Fac Med, IL-69978 Tel Aviv, Israel
[5] Tel Aviv Univ, Tel Aviv Med Ctr, Dept Oncol, IL-69978 Tel Aviv, Israel
关键词
Colorectal neoplasms; Laparoscopic resection; Blood transfusion; Prognosis; Long-term survival; LONG-TERM SURVIVAL; CURATIVE RESECTION; ASSISTED RESECTION; CYTOKINE RESPONSE; RANDOMIZED-TRIAL; COLON-CANCER; OPEN SURGERY; RECURRENCE; CARCINOMA; METAANALYSIS;
D O I
10.1007/s10151-013-1014-y
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Background Perioperative blood transfusion has been associated with a poor prognosis in patients undergoing surgery for colorectal cancer. The aim of this study was to evaluate risk factors for blood transfusion and its impact on long-term outcome exclusively in patients undergoing laparoscopic surgery for curable colorectal cancer. Data were retrieved from a prospectively collected database of patients who underwent laparoscopic surgery for curable colorectal cancer over a 6-year period. Long-term data were collected from our outpatient clinic and personal contact when necessary. Two hundred and one patients underwent laparoscopic surgery for curable colorectal cancer (stage I-III). Sixty-eight (33.8 %) received blood transfusions during or after surgery. These patients were typically older, had lower preoperative hemoglobin levels, had a more advanced cancer, had a higher Charlson score, had a higher rate of complications and had a higher conversion rate. Kaplan-Meier overall survival analysis was significantly worse in patients who received blood transfusions (P = 0.004). Decreased disease-free survival was also observed in transfused patients; however, this did not reach statistical significance (P = 0.21). A multivariate analysis revealed that transfusion was not an independent risk factor for decreased overall and disease-free survival. The Charlson score was the only independent risk factor for overall survival (OR = 2.1, P = 0.002). Independent factors affecting disease-free survival were stage of disease, Charlson score and, to a lesser degree, age and body mass index. Perioperative blood transfusion is associated with decreased long-term survival in patients undergoing laparoscopic resection for colorectal cancer. However, this association apparently reflects the poorer medical condition of patients requiring surgery and not a causative relationship.
引用
收藏
页码:549 / 554
页数:6
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