5313
document
Perioperative blood transfusions , with or without allogeneic leucocytes , relate to survival , not to cancer recurrence . 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 . METHODS 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 .
5314
Intervention_Pharmacological
Perioperative blood transfusions , with or without allogeneic leucocytes
5315
Intervention_Pharmacological
Perioperative blood transfusions
5316
Intervention_Pharmacological
Packed red cells without buffy coat ( PC group )
5317
Intervention_Control
filtered , leucoreduced , red cells ( LD group
5318
Intervention_Pharmacological
perioperative transfused blood
5319
Outcome_Mortality
survival
5320
Outcome_Physical
cancer recurrence
5321
Outcome_Physical
cancer recurrence
5322
Outcome_Mortality
reduced survival
5323
Outcome_Mortality
Five-year survival
5324
Outcome_Physical
cancer recurrence rates
5325
Outcome_Physical
location of recurrence
5326
Outcome_Mortality
survival rate
5327
Outcome_Physical
recurrence rates
5328
Outcome_Mortality
difference in survival
5329
Outcome_Physical
difference in cancer recurrence rate
5330
Outcome_Physical
Local recurrences
5331
Outcome_Mortality
long-term survival
5332
Outcome_Physical
cancer recurrence
5333
Outcome_Physical
recurrence rate