Perioperative transfusion decreased overall survival (HR 0.33; 95% CI 0.24 to 0.41; P<0.0001) and increased short-term complications in patients undergoing colorectal cancer surgery.
Meta-Analysis (n=174,036)
Does perioperative transfusion worsen survival and increase complications in patients undergoing colorectal cancer surgery?
Perioperative transfusion during colorectal cancer surgery is associated with worse long-term survival and increased short-term postoperative complications.
Hazard Ratio: 0.33 (95% CI 0.24–0.41)
p-value: p=< 0.0001
BACKGROUND: Perioperative transfusion can reduce the survival rate in colorectal cancer patients. The effects of transfusion on the short- and long-term prognoses are becoming intriguing. OBJECTIVE: This systematic review and meta-analysis aimed to define the effects of perioperative transfusion on the short- and long-term prognoses of colorectal cancer surgery. RESULTS: Thirty-six clinical observational studies, with a total of 174,036 patients, were included. Perioperative transfusion decreased overall survival (OS) (hazard ratio (HR), 0.33; 95% confidence interval (CI), 0.24 to 0.41; P < 0.0001) and cancer-specific survival (CSS) (HR, 0.34; 95% CI, 0.21 to 0.47; P < 0.0001), but had no effect on disease-free survival (DFS) (HR, 0.17; 95% CI, - 0.12 to 0.47; P = 0.248). Transfusion could increase postoperative infectious complications (RR, 1.89, 95% CI, 1.56 to 2.28; P < 0.0001), pulmonary complications (RR, 2.01; 95% CI, 1.54 to 2.63; P < 0.0001), cardiac complications (RR, 2.20; 95% CI, 1.75 to 2.76; P < 0.0001), anastomotic complications (RR, 1.51; 95% CI, 1.29 to 1.79; P < 0.0001), reoperation(RR, 2.88; 95% CI, 2.05 to 4.05; P < 0.0001), and general complications (RR, 1.86; 95% CI, 1.66 to 2.07; P < 0.0001). CONCLUSION: Perioperative transfusion causes a dramatically negative effect on long-term prognosis and increases short-term complications after colorectal cancer surgery.
Pang et al. (Sat,) conducted a meta-analysis in Colorectal cancer surgery (n=174,036). Perioperative transfusion vs. No transfusion was evaluated on Overall survival (OS) (HR 0.33, 95% CI 0.24 to 0.41, p=< 0.0001). Perioperative transfusion decreased overall survival (HR 0.33; 95% CI 0.24 to 0.41; P<0.0001) and increased short-term complications in patients undergoing colorectal cancer surgery.