Perioperative blood transfusions are associated with decreased time to recurrence and decreased survival after resection of colorectal liver metastases

K. R. Stephenson, S. M. Steinberg, K. S. Hughes, John Vetto, P. H. Sugarbaker, A. E. Chang

Research output: Contribution to journalArticle

211 Citations (Scopus)

Abstract

Data from fifty-five patients who had hepatic resections for colorectal liver metastases at the National Cancer Institute (NCI) were analyzed to determine the effect of perioperative blood transfusions on disease recurrence and overall survival. Besides blood transfusions, other factors included in the analysis were size, number, and distribution of metastases, margin status of resected metastases, length of disease-free interval, Duke's stage of the primary tumor, type of hepatic resection, and anesthesia time. Using the Cox proportional hazards model, the amount of blood transfused was found to be a significant prognostic factor. For each additional unit of blood transfused the risk of disease recurrence and death was increased by 5% (p = 0.0015) and 7% (p = 0.0013), respectively. The median disease-free survival for patients who received 3-5, 6-10, and ≥ 11 transfused units was 26, 12,1, and 11.4 months, respectively. The median overall survival for patients who received 3-5, 6-10, and ≥ 11 transfused units was > 44, 39.2, and 33.6 months, respectively. The number of resected nodules (1-2 vs. ≥ 3), type of resection (anatomic lobectomy vs. wedge resection), and nodule size (≤ 3.0 cm vs. > 3.0 cm) were additional factors that were further evaluated to determine the effect of blood transfusions. Analyses stratified for each of these factors revealed that patients who received ≥ 11 units of blood had a significantly decreased disease-free and overall survival compared with patients who received 3-10 units of blood. It is concluded that the amount of perioperative blood transfused is an independent prognostic factor that adversely effects disease-free and overall survival.

Original languageEnglish (US)
Pages (from-to)679-687
Number of pages9
JournalAnnals of Surgery
Volume208
Issue number6
StatePublished - 1988
Externally publishedYes

Fingerprint

Blood Transfusion
Neoplasm Metastasis
Recurrence
Survival
Liver
Disease-Free Survival
National Cancer Institute (U.S.)
Proportional Hazards Models
Anesthesia
Neoplasms

ASJC Scopus subject areas

  • Surgery

Cite this

Perioperative blood transfusions are associated with decreased time to recurrence and decreased survival after resection of colorectal liver metastases. / Stephenson, K. R.; Steinberg, S. M.; Hughes, K. S.; Vetto, John; Sugarbaker, P. H.; Chang, A. E.

In: Annals of Surgery, Vol. 208, No. 6, 1988, p. 679-687.

Research output: Contribution to journalArticle

Stephenson, K. R. ; Steinberg, S. M. ; Hughes, K. S. ; Vetto, John ; Sugarbaker, P. H. ; Chang, A. E. / Perioperative blood transfusions are associated with decreased time to recurrence and decreased survival after resection of colorectal liver metastases. In: Annals of Surgery. 1988 ; Vol. 208, No. 6. pp. 679-687.
@article{6901310893cc4bd88186084d44fdfcbf,
title = "Perioperative blood transfusions are associated with decreased time to recurrence and decreased survival after resection of colorectal liver metastases",
abstract = "Data from fifty-five patients who had hepatic resections for colorectal liver metastases at the National Cancer Institute (NCI) were analyzed to determine the effect of perioperative blood transfusions on disease recurrence and overall survival. Besides blood transfusions, other factors included in the analysis were size, number, and distribution of metastases, margin status of resected metastases, length of disease-free interval, Duke's stage of the primary tumor, type of hepatic resection, and anesthesia time. Using the Cox proportional hazards model, the amount of blood transfused was found to be a significant prognostic factor. For each additional unit of blood transfused the risk of disease recurrence and death was increased by 5{\%} (p = 0.0015) and 7{\%} (p = 0.0013), respectively. The median disease-free survival for patients who received 3-5, 6-10, and ≥ 11 transfused units was 26, 12,1, and 11.4 months, respectively. The median overall survival for patients who received 3-5, 6-10, and ≥ 11 transfused units was > 44, 39.2, and 33.6 months, respectively. The number of resected nodules (1-2 vs. ≥ 3), type of resection (anatomic lobectomy vs. wedge resection), and nodule size (≤ 3.0 cm vs. > 3.0 cm) were additional factors that were further evaluated to determine the effect of blood transfusions. Analyses stratified for each of these factors revealed that patients who received ≥ 11 units of blood had a significantly decreased disease-free and overall survival compared with patients who received 3-10 units of blood. It is concluded that the amount of perioperative blood transfused is an independent prognostic factor that adversely effects disease-free and overall survival.",
author = "Stephenson, {K. R.} and Steinberg, {S. M.} and Hughes, {K. S.} and John Vetto and Sugarbaker, {P. H.} and Chang, {A. E.}",
year = "1988",
language = "English (US)",
volume = "208",
pages = "679--687",
journal = "Annals of Surgery",
issn = "0003-4932",
publisher = "Lippincott Williams and Wilkins",
number = "6",

}

TY - JOUR

T1 - Perioperative blood transfusions are associated with decreased time to recurrence and decreased survival after resection of colorectal liver metastases

AU - Stephenson, K. R.

AU - Steinberg, S. M.

AU - Hughes, K. S.

AU - Vetto, John

AU - Sugarbaker, P. H.

AU - Chang, A. E.

PY - 1988

Y1 - 1988

N2 - Data from fifty-five patients who had hepatic resections for colorectal liver metastases at the National Cancer Institute (NCI) were analyzed to determine the effect of perioperative blood transfusions on disease recurrence and overall survival. Besides blood transfusions, other factors included in the analysis were size, number, and distribution of metastases, margin status of resected metastases, length of disease-free interval, Duke's stage of the primary tumor, type of hepatic resection, and anesthesia time. Using the Cox proportional hazards model, the amount of blood transfused was found to be a significant prognostic factor. For each additional unit of blood transfused the risk of disease recurrence and death was increased by 5% (p = 0.0015) and 7% (p = 0.0013), respectively. The median disease-free survival for patients who received 3-5, 6-10, and ≥ 11 transfused units was 26, 12,1, and 11.4 months, respectively. The median overall survival for patients who received 3-5, 6-10, and ≥ 11 transfused units was > 44, 39.2, and 33.6 months, respectively. The number of resected nodules (1-2 vs. ≥ 3), type of resection (anatomic lobectomy vs. wedge resection), and nodule size (≤ 3.0 cm vs. > 3.0 cm) were additional factors that were further evaluated to determine the effect of blood transfusions. Analyses stratified for each of these factors revealed that patients who received ≥ 11 units of blood had a significantly decreased disease-free and overall survival compared with patients who received 3-10 units of blood. It is concluded that the amount of perioperative blood transfused is an independent prognostic factor that adversely effects disease-free and overall survival.

AB - Data from fifty-five patients who had hepatic resections for colorectal liver metastases at the National Cancer Institute (NCI) were analyzed to determine the effect of perioperative blood transfusions on disease recurrence and overall survival. Besides blood transfusions, other factors included in the analysis were size, number, and distribution of metastases, margin status of resected metastases, length of disease-free interval, Duke's stage of the primary tumor, type of hepatic resection, and anesthesia time. Using the Cox proportional hazards model, the amount of blood transfused was found to be a significant prognostic factor. For each additional unit of blood transfused the risk of disease recurrence and death was increased by 5% (p = 0.0015) and 7% (p = 0.0013), respectively. The median disease-free survival for patients who received 3-5, 6-10, and ≥ 11 transfused units was 26, 12,1, and 11.4 months, respectively. The median overall survival for patients who received 3-5, 6-10, and ≥ 11 transfused units was > 44, 39.2, and 33.6 months, respectively. The number of resected nodules (1-2 vs. ≥ 3), type of resection (anatomic lobectomy vs. wedge resection), and nodule size (≤ 3.0 cm vs. > 3.0 cm) were additional factors that were further evaluated to determine the effect of blood transfusions. Analyses stratified for each of these factors revealed that patients who received ≥ 11 units of blood had a significantly decreased disease-free and overall survival compared with patients who received 3-10 units of blood. It is concluded that the amount of perioperative blood transfused is an independent prognostic factor that adversely effects disease-free and overall survival.

UR - http://www.scopus.com/inward/record.url?scp=0024204933&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0024204933&partnerID=8YFLogxK

M3 - Article

VL - 208

SP - 679

EP - 687

JO - Annals of Surgery

JF - Annals of Surgery

SN - 0003-4932

IS - 6

ER -