Association of preoperative anemia and perioperative allogenic red blood cell transfusion with oncologic outcomes in patients with nonmetastatic colorectal cancer

H. Y. Kwon, B. R. Kim, Young Wan Kim

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Abstract

Background We investigated whether preoperative anemia and perioperative blood transfusion (PBT) are associated with overall survival and recurrence-free survival in patients with nonmetastatic colorectal cancer. Methods From 1 January 2009 to 31 December 2014, 1003 patients with primary colorectal cancer were enrolled in the study. Perioperative clinical and oncologic outcomes were analyzed based on the presence of preoperative anemia and PBT. Results Preoperative anemia was found in 468 patients (46.7%). In the anemia and no-anemia groups, PBT was performed in 44% and 15% of patients respectively. Independent predictors for PBT were preoperative anemia, higher American Society of Anesthesiologists score, laparotomy, lengthy operative time, advanced TNM stage, T4 stage, and 30-day morbidity. The use of PBT, but not preoperative anemia, was found to be an independent adverse prognostic factor for overall survival. In terms of recurrence-free survival, the presence of preoperative anemia was similarly not a significant prognostic factor, but the use of PBT was an independent factor for an unfavourable prognosis. Conclusions The use of PBT, but not preoperative anemia, was independently associated with worse overall and recurrence-free survival in nonmetastatic colorectal cancer. For better oncologic outcomes, our findings indicate a need to reduce the use of blood transfusion during the perioperative period.

Original languageEnglish
Pages (from-to)e357-e366
JournalCurrent Oncology
Volume26
Issue number3
DOIs
Publication statusPublished - 2019 Jan 1

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Erythrocyte Transfusion
Anemia
Colorectal Neoplasms
Blood Transfusion
Survival
Recurrence
Perioperative Period
Operative Time
Laparotomy
Morbidity

All Science Journal Classification (ASJC) codes

  • Oncology

Cite this

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title = "Association of preoperative anemia and perioperative allogenic red blood cell transfusion with oncologic outcomes in patients with nonmetastatic colorectal cancer",
abstract = "Background We investigated whether preoperative anemia and perioperative blood transfusion (PBT) are associated with overall survival and recurrence-free survival in patients with nonmetastatic colorectal cancer. Methods From 1 January 2009 to 31 December 2014, 1003 patients with primary colorectal cancer were enrolled in the study. Perioperative clinical and oncologic outcomes were analyzed based on the presence of preoperative anemia and PBT. Results Preoperative anemia was found in 468 patients (46.7{\%}). In the anemia and no-anemia groups, PBT was performed in 44{\%} and 15{\%} of patients respectively. Independent predictors for PBT were preoperative anemia, higher American Society of Anesthesiologists score, laparotomy, lengthy operative time, advanced TNM stage, T4 stage, and 30-day morbidity. The use of PBT, but not preoperative anemia, was found to be an independent adverse prognostic factor for overall survival. In terms of recurrence-free survival, the presence of preoperative anemia was similarly not a significant prognostic factor, but the use of PBT was an independent factor for an unfavourable prognosis. Conclusions The use of PBT, but not preoperative anemia, was independently associated with worse overall and recurrence-free survival in nonmetastatic colorectal cancer. For better oncologic outcomes, our findings indicate a need to reduce the use of blood transfusion during the perioperative period.",
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T1 - Association of preoperative anemia and perioperative allogenic red blood cell transfusion with oncologic outcomes in patients with nonmetastatic colorectal cancer

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AU - Kim, B. R.

AU - Kim, Young Wan

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N2 - Background We investigated whether preoperative anemia and perioperative blood transfusion (PBT) are associated with overall survival and recurrence-free survival in patients with nonmetastatic colorectal cancer. Methods From 1 January 2009 to 31 December 2014, 1003 patients with primary colorectal cancer were enrolled in the study. Perioperative clinical and oncologic outcomes were analyzed based on the presence of preoperative anemia and PBT. Results Preoperative anemia was found in 468 patients (46.7%). In the anemia and no-anemia groups, PBT was performed in 44% and 15% of patients respectively. Independent predictors for PBT were preoperative anemia, higher American Society of Anesthesiologists score, laparotomy, lengthy operative time, advanced TNM stage, T4 stage, and 30-day morbidity. The use of PBT, but not preoperative anemia, was found to be an independent adverse prognostic factor for overall survival. In terms of recurrence-free survival, the presence of preoperative anemia was similarly not a significant prognostic factor, but the use of PBT was an independent factor for an unfavourable prognosis. Conclusions The use of PBT, but not preoperative anemia, was independently associated with worse overall and recurrence-free survival in nonmetastatic colorectal cancer. For better oncologic outcomes, our findings indicate a need to reduce the use of blood transfusion during the perioperative period.

AB - Background We investigated whether preoperative anemia and perioperative blood transfusion (PBT) are associated with overall survival and recurrence-free survival in patients with nonmetastatic colorectal cancer. Methods From 1 January 2009 to 31 December 2014, 1003 patients with primary colorectal cancer were enrolled in the study. Perioperative clinical and oncologic outcomes were analyzed based on the presence of preoperative anemia and PBT. Results Preoperative anemia was found in 468 patients (46.7%). In the anemia and no-anemia groups, PBT was performed in 44% and 15% of patients respectively. Independent predictors for PBT were preoperative anemia, higher American Society of Anesthesiologists score, laparotomy, lengthy operative time, advanced TNM stage, T4 stage, and 30-day morbidity. The use of PBT, but not preoperative anemia, was found to be an independent adverse prognostic factor for overall survival. In terms of recurrence-free survival, the presence of preoperative anemia was similarly not a significant prognostic factor, but the use of PBT was an independent factor for an unfavourable prognosis. Conclusions The use of PBT, but not preoperative anemia, was independently associated with worse overall and recurrence-free survival in nonmetastatic colorectal cancer. For better oncologic outcomes, our findings indicate a need to reduce the use of blood transfusion during the perioperative period.

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