Perioperative blood transfusions reduce long-term survival following surgery for colorectal cancer
Perioperative blood transfusions reduce long-term survival following surgery for colorectal cancer
复制标题
DOI：
10.1007/bf02235758
复制
发表时间：
1998-04-01
影响因子：
3.9
通讯作者：
Bjerkeset, T
中科院分区：
文献类型：
--
作者：
Edna, TH;Bjerkeset, T
目得：本研究的目的是研究输血与结直肠癌患者长期预后之间的关系，并控制其他预后因素的影响。我们还想研究血液储存时间是否影响预后。方法：采用考克斯比例风险回归分析对336例根治性切除术后存活的患者的数据进行分析。中位随访时间为5.8（2-16.8）年或直至死亡。结果：当输血超过两个单位时，局部复发和远处转移的频率明显更高。在多变量考克斯分析中，向后消除10%水平的非显著性因素，以下危险因素与结直肠癌死亡显著相关：肿瘤分期（T期和N期）、肿瘤穿孔、年龄和输血需求。输注超过两个单位的血液与结直肠癌死亡独立且显著相关（相对危险度，2.7; 95%置信区间，1.4-5.2）。贮血时间对红细胞无影响。在死于与结直肠癌无关的疾病的患者中，年龄和美国麻醉医师协会组与死亡显著相关，而输血则无关。结论：我们发现围手术期输血与结直肠癌患者预后不良之间存在独立且显著的相关性。血液储存时间不是预后因素。
PURPOSE: The aim of the study contained herein was to investigate the association between blood transfusion and long-term outcome for patients treated for colorectal cancer, controlling for the effect of other prognostic factors. We also wanted to study whether blood storage time influenced the prognosis. METHODS: Cox's proportional hazards regression analysis was used to analyze data from 336 patients who survived resection with curative intent. Median follow-up was 5.8 (2-16.8) years or until death. RESULTS: Local recurrences and distant metastases were significantly more frequent when more than two units of blood had been transfused. In the multivariate Cox's analysis, with backward elimination of nonsignificant factors at the 10 percent level, the following risk factors were significantly related to death by colorectal cancer: tumor stage (T stage and N stage), perforation of tumor, age, and the need for a blood transfusion. Transfusions of more than two units of blood were independently and significantly associated with death from colorectal cancer (relative hazard, 2.7; 95 percent confidence intervals, 1.4-5.2). Time of blood storage had no effect on the prognoses. In patients dying from diseases unrelated to colorectal cancer, age and American Society of Anesthesiologists group were significantly related to death, whereas blood transfusion was not. CONCLUSION: We found an independent and significant association between perioperative blood transfusion and poor prognosis in colorectal cancer patients. Blood storage time was not a prognostic factor.