Preoperative anaemia and perioperative red blood cell transfusion as prognostic factors for recurrence and mortality in colorectal cancer-a Swedish cohort study

被引:40
作者
Morner, Malin E. M. [1 ,2 ]
Edgren, Gustaf [3 ]
Martling, Anna [4 ,5 ]
Gunnarsson, Ulf [6 ]
Egenvall, Monika [4 ,5 ]
机构
[1] Karolinska Inst, Dept Clin Sci Intervent & Technol, Stockholm, Sweden
[2] Karolinska Univ Hosp, Funct Area Emergency Med Huddinge, C1 63, S-14186 Stockholm, Sweden
[3] Karolinska Inst, Dept Med Epidemiol & Biostat, Stockholm, Sweden
[4] Karolinska Inst, Dept Mol Med & Surg, Stockholm, Sweden
[5] Karolinska Univ Hosp, Ctr Digest Dis, P9 03, Solna, Sweden
[6] Umea Univ, Dept Surg & Perioperat Sci, Umea, Sweden
关键词
Anaemia; Transfusion; Colorectal cancer; Recurrence; Mortality; Survival; PREVALENCE;
D O I
10.1007/s00384-016-2678-3
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
The hypothesis in this study was that anaemia prior to surgery and perioperative red blood cell transfusion increases the risk for recurrence and overall mortality in patients with stages I-III colorectal cancer after abdominal resection with curative intent. This is a Swedish single centre retrospective cohort study. Data on 496 consecutive radical abdominal resections stages I-III colorectal cancer performed at the Karolinska University Hospital 2007-2010 were extracted from the Swedish Colorectal Cancer Registry. Data were linked to local laboratory and transfusion databases to identify preoperative anaemia and perioperative transfusion. Disease recurrence was validated by scrutiny of patient records. A total of 496 stages I-III colorectal cancer patients were included in the analysis. Multivariate Cox regression analysis adjusted for tumour and patient characteristics were performed to assess risk for recurrence and overall mortality. Anaemia prior to surgery was associated with increased risk for overall mortality (HR 2.1, 95% CI 1.4-3.2). There was no association between anaemia and risk for recurrence (HR 1.6, 95% CI 0.97-2.6). Transfusion was not associated with increased risk of recurrence (HR 0.7, 95% CI 0.4-1.3) or overall mortality (HR 1.04, 95% CI 0.7-1.6). Anaemia prior to colorectal cancer surgery was associated with increased risk for overall mortality while a no increased risk was seen for recurrence. Previous findings indicating an association between blood transfusion and increased risk for recurrence could not be confirmed.
引用
收藏
页码:223 / 232
页数:10
相关论文
共 24 条
  • [1] Perioperative blood transfusions for the recurrence of colorectal cancer
    Amato, A
    Pescatori, M
    [J]. COCHRANE DATABASE OF SYSTEMATIC REVIEWS, 2006, (01):
  • [2] Effect of perioperative blood transfusions on recurrence of colorectal cancer - Meta-analysis stratified on risk factors
    Amato, AC
    Pescatori, M
    [J]. DISEASES OF THE COLON & RECTUM, 1998, 41 (05) : 570 - 585
  • [3] [Anonymous], 2018, ANTI-CANCER DRUG, DOI [DOI 10.3322/caac.20115, DOI 10.1097/CAD.0000000000000617]
  • [4] Bohe M, 2008, KOLOREKTAL CANC
  • [5] Immunological aspects of blood transfusions
    Brand, A
    [J]. TRANSPLANT IMMUNOLOGY, 2002, 10 (2-3) : 183 - 190
  • [6] Prevalence of Anaemia at Diagnosis of Colorectal Cancer: Assessment of Associated Risk Factors
    Edna, Tom-Harald
    Karlsen, Vegard
    Jullumstro, Eivind
    Lydersen, Stian
    [J]. HEPATO-GASTROENTEROLOGY, 2012, 59 (115) : 713 - 716
  • [7] Guidelines for the management of iron deficiency anaemia
    Goddard, Andrew F.
    James, Martin W.
    McIntyre, Alistair S.
    Scott, Brian B.
    [J]. GUT, 2011, 60 (10) : 1309 - 1316
  • [8] Registration and validity of surgical complications in colorectal cancer surgery
    Gunnarsson, U
    Seligsohn, E
    Jestin, P
    Påhlman, L
    [J]. BRITISH JOURNAL OF SURGERY, 2003, 90 (04) : 454 - 459
  • [9] Effect of Plasma-to-RBC Ratios in Trauma Patients: A Cohort Study With Time-Dependent Data
    Halmin, Marit
    Bostrom, Fredrik
    Brattstrom, Olof
    Lundahl, Joachim
    Wikman, Agneta
    Ostlund, Anders
    Edgren, Gustaf
    [J]. CRITICAL CARE MEDICINE, 2013, 41 (08) : 1905 - 1914
  • [10] THE RESTRICTED CUBIC SPLINE AS BASE-LINE HAZARD IN THE PROPORTIONAL HAZARDS MODEL WITH STEP-FUNCTION TIME-DEPENDENT COVARIABLES
    HERNDON, JE
    HARRELL, FE
    [J]. STATISTICS IN MEDICINE, 1995, 14 (19) : 2119 - 2129