Perioperative Allogeneic Blood Transfusion, the Related Cytokine Response and Long-term Survival After Potentially Curative Resection of Colorectal Cancer

Miki, Chikao; Hiro, J.; Ojima, Eiki; Inoue, Yasuhiro; Mohri, Yasuhiko; Kusunoki, Masato

doi:10.1016/j.clon.2005.08.004

Cited by 99 publications

(70 citation statements)

References 26 publications

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“…In addition to the amount of transfused blood units, longterm prognosis may be affected by circumstances under which they are applied. Miki et al [17] reported that preoperative blood transfusion for correcting anemia was not associated with survival, whereas intraoperative blood transfusion due to excessive blood loss affected long-term prognosis. Blood transfusion under intense surgical stress synergistically exaggerates postoperative systemic inflammatory response, which may have effect on minimal residual disease in resected cancer patients.…”

Section: Discussionmentioning

confidence: 99%

Impact of Blood Transfusions on Survival and Recurrence in Colorectal Cancer Surgery

et al. 2012

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The aim of our study was to evaluate the prognostic significance of blood transfusion on recurrence and survival in patients undergoing curative resections for colorectal cancer. Retrospective analysis of prospectively collected data of patients after elective resections for colorectal cancer between January 2001 and December 2009 was undertaken. The main endpoint was overall survival, disease-free survival, and recurrence rate. These data were evaluated in relation to blood transfusion (group A, no blood transfusion; group B, one to two blood transfusions; group C, three and more blood transfusions). A total of 583 patients met the criteria for inclusion in the study. Of these, 132 (22.6 %) patients received blood transfusion in the perioperative period. There were 83 (14.2 %) patients who received one or two blood transfusions and 49 (8.4 %) patients who required three or more transfusions. Patients with three or more transfusions had a significantly worse 5-year overall survival, disease-free survival, and increased incidence of distant recurrences in comparison with the group without transfusion or the group with one or two transfusions. Multivariate analysis showed that the application of three or more blood transfusions is an independent risk factor for overall survival (P 00.001; HR 2.158; 95 % CI 1.370-3.398), disease-free survival (P<0.001; HR 2.514; 95 % CI 1.648-3.836), and the incidence of distant recurrence (P<0.001; HR 2.902; 95 % CI 1.616-5.212). Application of three or more blood transfusions in patients operated for colorectal carcinoma is an adverse prognostic factor. Indications for blood transfusion should be carefully considered not only with regard to the risk of early complications, but also because of the possibility of compromising long-term results.

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Section: Discussionmentioning

confidence: 99%

Impact of Blood Transfusions on Survival and Recurrence in Colorectal Cancer Surgery

et al. 2012

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“…However, only 7 of these studies 5,7À10,14,15 used multivariate analysis and of these studies, 3 found an independent association 5,14,15 (Table 6). Eleven studies [3][4][5][6][7][8][9][10][12][13][14] tested the impact of blood transfusions on overall survival. Of these, 6 studies 4-6,9,10,14 found an independent association (Table 1).…”

Section: Discussionmentioning

confidence: 99%

Comparing Survival and Recurrence in Curative Stage I to III Colorectal Cancer in Transfused and Nontransfused Patients

Talukder

Stillwell

Siu

et al. 2014

International Surgery

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Evidence of the association between blood transfusions and its impact on prognostic outcomes in patients who undergo curative resection of colorectal cancer remains controversial. The aim of this study was to determine whether receiving peri-operative blood transfusions during curative colorectal cancer resection affected overall survival, cancer-related survival, and cancer recurrence. This retrospective study was undertaken at The Royal Brisbane and Women's Hospital, Australia, between 1984 and 2004. The outcomes of 1370 patients undergoing curative colorectal cancer resection for TNM stage I to III were analyzed. Four hundred twenty three patients (30.9%) required transfusion and 947 patients (69.1%) did not. Peri-operative transfusion was associated with higher rates of cancer recurrence on multivariate analysis (P ¼ 0.024, RR, 1.257, 95% CI, 1.03-1.53); however, it was not independently associated with poorer overall or cancer-related survival. Where the aim is curative resection, this study contributes to a body of evidence that blood transfusions may be associated with poorer outcomes.

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“…Furthermore, the study by Miki et al in the same patients demonstrated that the plasma level of IL-6 is elevated in transfused patients (23).…”

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confidence: 90%

TNF-α and TGF-β level after intraoperative allogeneic red blood cell transfusion in orthopedic operation patients

Hassani¹,

Khoshdel²,

Sharifzadeh³

et al. 2017

Turk J Med Sci

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Background/aim: Blood transfusion is associated with immunosuppression, referred to as transfusion-related immunomodulation (TRIM). In this study, for the first time, changes in the concentration of TGF-β and TNF-α were measured postoperatively in orthopedic patients with intraoperational allogeneic red blood cell transfusion. Considering the use of packed cell units with different ages, it is possible to suggest the more appropriate product for clinical applications.Materials and methods: Two groups of 35 orthopedic surgery patients (with or without transfusion as case and control groups, respectively) were involved. Serum levels of TNF-α and TGF-β were measured by ELISA. Results:The data suggested significant differences in age (P = 0.0001), lowered hemoglobin (P = 0.003), and hematocrit (P = 0.003) between the control and case groups. Pre-and postoperation levels of TNF-α and TGF-βwere not significantly different, but the results showed significant increases in levels of both cytokines after the operation (P = 0.0001) in both groups. Conclusion:Increased levels of TNF-α and TGF-β are probably related to surgery and packed cell transfusion, respectively. Further studies using more packed cell units or other blood products and assessment of more cytokines are needed to have better understanding about this issue.

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Perioperative Allogeneic Blood Transfusion, the Related Cytokine Response and Long-term Survival After Potentially Curative Resection of Colorectal Cancer

Cited by 99 publications

References 26 publications

Impact of Blood Transfusions on Survival and Recurrence in Colorectal Cancer Surgery

Impact of Blood Transfusions on Survival and Recurrence in Colorectal Cancer Surgery

Comparing Survival and Recurrence in Curative Stage I to III Colorectal Cancer in Transfused and Nontransfused Patients

TNF-α and TGF-β level after intraoperative allogeneic red blood cell transfusion in orthopedic operation patients

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