Perioperative Blood Transfusion Impairs Overall Survival Following Radical Resection for Colorectal Cancer: A...

Area of Science:

• Oncology
• Surgical Oncology
• Transfusion Medicine

Background:

• Perioperative blood transfusion (BTF) impact on colorectal cancer (CRC) oncological outcomes is debated.
• Radical resection for CRC involves potential risks including BTF.

Purpose of the Study:

• To evaluate the association between BTF, transfusion volume, and long-term prognosis in CRC patients.
• To determine if BTF independently affects overall survival (OS) after CRC surgery.

Main Methods:

• Retrospective cohort study of 1777 CRC patients undergoing radical surgery.
• Propensity score matching (PSM) used to control for confounding factors.
• Cox proportional hazards models and X-tile analysis assessed BTF and transfusion volume impact on 5-year OS.

Main Results:

• 41.02% of patients received BTF; intestinal obstruction was associated with BTF need.
• BTF was independently associated with inferior 1-, 3-, and 5-year OS (HR=1.44).
• Massive-volume transfusion (>4 units) showed the poorest survival outcomes and was an independent predictor of worse OS (HR=1.61).

Conclusions:

• BTF, especially >4 units, independently predicts inferior long-term survival in CRC patients post-resection.
• Findings support restrictive transfusion strategies in perioperative CRC management.
• Study highlights association, not causality, due to retrospective design.