This is the Scientific Surgery Archive, which contains all randomized clinical trials in surgery that have been identified by searching the top 50 English language medical journal issues since January 1998. Compiled by Jonothan J. Earnshaw, former Editor-in-Chief, BJS
Perioperative blood transfusions, with or without allogeneic leucocytes, relate to survival, not to cancer recurrence. BJS 2001; 88: 267-272.
Published: 6th December 2002
Authors: L. M. G. van de Watering, A. Brand, J. G. A. Houbiers, W. M. Klein Kranenbarg, J. Hermans, C. J. H. van de Velde et al.
Background
Perioperative blood transfusions are reported to be related to cancer recurrence and reduced survival. Different underlying mechanisms have been proposed, and allogeneic leucocytes in transfused blood have been suggested to contribute to this phenomenon.
Method
Packed red cells without buffy coat (PC group) were compared with filtered, leucoreduced, red cells (LD group) in a randomized trial of 697 patients with colorectal carcinoma. Five‐year survival and cancer recurrence rates were determined, with special emphasis on the location of recurrence.
Results
The intention‐to‐treat analysis showed a survival rate of 63·6 per cent in the PC group and 65·3 per cent in the LD group (P = 0·69), with recurrence rates of 27·8 and 27·9 per cent respectively. The observational analysis showed a significant difference in survival between transfused and non‐transfused patients (59·6 versus 72·9 per cent; P < 0·001). The difference in cancer recurrence rate between transfused and non‐transfused patients was not statistically significant (29·8 versus 24·3 per cent; P = 0·13). Local recurrences were more frequent in transfused than non‐transfused patients (11·9 versus 7·6 per cent; P = 0·09).
Conclusion
Leucocyte depletion of perioperative transfused blood has no effect on long‐term survival and/or cancer recurrence. Perioperative blood transfusions are associated with impaired survival, but not with cancer recurrence. The slight increase in local recurrence rate in transfused patients appears to be related to complicated, in particular rectal, surgery. © 2001 British Journal of Surgery Society Ltd
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