OBJECTIVE. The authors analyzed the effect of blood transfusions on the
pattern of colorectal cancer recurrence. BACKGROUND. Retrospective studies
suggest that blood transfusions are associated with a poor prognosis in
patients who undergo operations for colorectal malignancies. In a
previously published, randomized trial, it was investigated whether
autologous blood transfusions could overcome this putative detrimental
effect. However, this did not appear to be the case. METHODS. In the
current study, the authors analyzed the patterns of recurrence in 420
patients who underwent curative operations for colorectal cancer. RESULTS.
Patients who did not require transfusions (N = 143) had significantly
better disease-free survival than those who did need transfusions (N =
277); percentages at 4 years were 73% and 59%, respectively (p = 0.001).
No difference was found between both groups in comparing cumulative
percentages of patients having metastases; percentages at 4 years were 25%
in the group that did not undergo transfusion and 27% in the transfused
group. The percentage of cases having local recurrence, however, was
significantly increased (p = 0.0006) in the transfused group as compared
with the group that did not undergo transfusion; percentages at 4 years
were 20% and 3%, respectively. The groups of patients receiving only
allogeneic, only autologous, or both types of transfusions all had a
significantly higher incidence of local recurrence than the patients who
did not receive transfusions, but no differences were found between these
three groups. CONCLUSIONS. These findings suggest that the association
between blood transfusions and prognosis in colorectal cancer is a result
of the circumstances that necessitate transfusions, leading to the
development of local recurrences, but not of distant metastases