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J Korean Cancer Assoc > Volume 27(3); 1995 > Article
Journal of the Korean Cancer Association 1995;27(3): 403-411.
수술 전후의 수혈이 대장 및 직장암 환자의 예후에 미치는 영향
최희정, 최진혁, 이순남, 박응범, 이경자
The Effect of Perioperative Blood Transfusion on the Prognosis of Colorectal Cancer Patients
Hee Jung Choi, Jin Hyuk Choi, Soon Nam Lee, Eung Bum Park, Kyung Ja Lee
Except for the weli known prognostic factors of cancer, the studies that perioperative transfusion of surgically resectable cancer could influence the survival of cancer patients were continued to be investigated. The explanation of deleterious effects of transfusion has been supported by the results that the incidences of renal allograft rejection were decreased by pretransplantation tranafusion, and transfusion resulted in changes of mononuclear cell function and inhibited natural killer cell activity. But definite proof of this adverse eifect has not been settled. We investigated whether perioperative transfusion can diminish the eurvival rate of patients with colorectal cancer and transfusion itself can become prognostic factor by way of retrospec- tive analysis of 104 surgically resected colorectal cancer patients. Five year survival rate of 46.2% in transfusion group(n=53) is significantly decreased compared with the rate of 73.8% in non-transfusion group(n=51) (P<0.05). In subgroup analysis, there is no difference in survival rate by stage, the amount and component of blood transfusion. There are many other variables that can affect survival rate of cancer patient except for transfusion, multivariate Cox regression analysis was performed. The tumor differentiation is the greatest relative risk, but transfusion itself is not an independent prognostic value. In conclusion, perioperative transfusion and the swvival rate did not show direct relationship in these surgically resected coiorectal cancer patients. Nevertheless the difference in survival rate between transfusion group and non-transfusion group is significant, judicious use of blood products, use of frozen washed red blood cells that are totally lacking in white cells might be necessary. To confirm the direct causal relationship between perioperative transfusion and the survival in colorectal cancer, the larger prospective investigations are thought to be needed.
Key words: Transfusion, Colorectal cancer
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