THE ASSOCIATION OF PERIOPERATIVE BLOOD-TRANSFUSION WITH COLORECTAL-CANCER RECURRENCE
THE ASSOCIATION OF PERIOPERATIVE BLOOD-TRANSFUSION WITH COLORECTAL-CANCER RECURRENCE
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DOI：
10.1097/00000658-199212000-00004
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发表时间：
1992-12-01
影响因子：
9
通讯作者：
TARTTER, PI
中科院分区：
文献类型：
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作者：
TARTTER, PI
对 339 名连续结直肠癌患者进行了前瞻性研究，研究了输血、无病生存率和其他潜在预后因素之间的关系。入院和出院血细胞比容、Dukes 分期和失血量与输血和无病生存显着相关。然而，使用 Cox 比例风险模型，在控制年龄、性别、失血量、手术、肿瘤分化、分期、入院血细胞比容、手术持续时间、标本长度和肿瘤大小后，输血与无病生存率显着相关 (p = 0.0196)。 Dukes 分期 (p < 0.0001) 和输血 (p < 0.0001) 是唯一与无病生存率独立相关的变量。 110 名接受输血的患者中有 40% (44) 出现癌症复发，而 229 名未接受输血的患者中有 22% (50) 出现癌症复发 (p < 0.0001)。输血患者的五年无病生存率为 57%，而未输血患者的五年无病生存率为 77%。发生复发的患者接受的血液平均是未复发患者的两倍（1.26 vs 0.61 单位，p = 0.0128）。围手术期输血是结直肠癌重要的独立预后因素。
The relationship between blood transfusion, disease-free survival, and other potential prognostic factors was prospectively studied in 339 consecutive patients with colorectal cancer. Admission and discharge hematocrit, Dukes' stage, and blood loss were significantly related to both blood transfusion and disease-free survival. Using Cox proportional hazards model, however, the association of transfusion with disease-free survival was significant (p = 0.0196) after controlling for age, sex, blood loss, procedure, tumor differentiation, stage, admission hematocrit, duration of surgery, length of the specimen, and tumor size. Dukes' stage (p < 0.0001) and blood transfusion (p < 0.0001) were the only variables independently related to disease-free survival. Forty per cent (44) of the 110 patients who received transfusions developed cancer recurrence, compared with 22% (50) of the 229 patients who did not receive blood (p < 0.0001). Five-year disease-free survival of the transfused patients was 57%, compared with 77% for nontransfused patients. Patients who developed recurrence received an average of twice as much blood as patients without recurrence (1.26 versus 0.61 units, p = 0.0128). Perioperative blood transfusion is a significant independent prognostic factor for colorectal cancer.