Perioperative blood transfusion does not increase the risk of colorectal cancer recurrence

An adverse relationship between perioperative blood transfusions and the risk of subsequent recurrence of cancer was reported recently. We reviewed retrospectively the records of 171 patients who received initial therapy for colorectal adenocarcinoma from 1977 to 1979 at the Virginia Mason Medical Center. One hundred three patients (60%) received transfusions within 1 month of surgery and 37 patients (22%) developed recurrent cancer. No overall relationship between transfusion status (yes or no) and tumor recurrence or patient survival was found, although among subsets of patients (those with colon cancer or Dukes' Stage C2 disease), patients who had received transfusions were less likely to develop recurrent cancer than patients who had not (P = 0.01). No effect of transfusion on patient survival was found, even after consideration of potential confounding variables. The conflicting data regarding blood transfusion and cancer recurrence are reviewed, but it would appear to be premature to alter radically current blood transfusion practices based on the possibility that transfusion may adversely influence the risk of cancer recurrence.