[Effect of blood transfusion on prognosis of colorectal cancer patients]

Abstract

To evaluate the effect of blood transfusion on prognosis of colorectal cancer, data of 592 patients having been operated on in our department were analyzed using Cox method, logistic regression and Mantel-Haenszel test. The predictor variables were age, tumor location, Turnbull's modification of Dukes stage, preoperative hemoglobin (HB), anesthetic time (AT), perioperative blood transfusion (BT), and intraoperative blood loss (BL). Cox analysis showed that the most significant prognostic factors were Stage and BT (p less than 0.001), followed by location and BL. Logistic analysis also revealed that Stage and BT were significant predictors of 1-year and 5-year survivals. Similar results were obtained by Mantel-Haenszel test in which the patients were stratified by Stage, and grouped by HB, BT and BL. BT was a significant factor whereas BL and HB did not achieve statistical significance. We conclude that BT is an important prognostic factor unrelated to other variables and its adverse effect on survival is of higher significance than BL and HB. Some measures including clinical decision analysis were proposed to avoid unnecessary blood transfusion in surgery.