Peri-operative blood transfusion for resected colon cancer: Practice patterns and outcomes in a population-based study |
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| Affiliation: | 1. Department of Oncology, Queen’s University, Kingston, Canada;2. Department of Surgery, Queen’s University, Kingston, Canada;3. Division of Cancer Care and Epidemiology, Queen’s University Cancer Research Institute, Canada;1. BioForum, Applied Knowledge Center, Ness-Ziona, Israel;2. University of Gerona, Gerona, Spain;1. Faculty of Health Sciences of the University of Beira Interior, Av. Infante D. Henrique, 6200-506 Covilhã, Portugal;2. Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, SE 701 82 Örebro, Sweden;3. Department of Statistics, Örebro University, 701 82, Örebro, Sweden;4. Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, SE 171 77, Stockholm, Sweden;5. Clinical Epidemiology Unit, Department of Medicine, Karolinska University Hospital, Solna, Karolinska Institutet, SE 171 76 Stockholm, Sweden;6. Department of Epidemiology and Public Health, University College, WC1E 6BT London, UK;1. Department of Pediatrics, Chung-Ang University Hospital, Seoul, Republic of Korea;2. Department of Internal Medicine, Nasaret International Hospital, Incheon, Republic of Korea;3. Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea;4. College of Medicine, Chung-Ang University, Seoul, Republic of Korea;5. Department of Pediatrics, Asan Medical Center, Children’s Hospital, University of Ulsan College of Medicine, Seoul, Republic of Korea;1. Biomedical Research Foundation, House # 7, Apartment # 1A, Road # 1/B, Chairman Bari, Banani, Dhaka 1213, Bangladesh;2. Department of Genetic Engineering and Biotechnology, Faculty of Biological Sciences, University of Chittagong, Chittagong 4331, Bangladesh;3. School of Environmental Science and Management, Independent University, Bangladesh;1. Centre for Public Health Research, Massey University-Wellington Campus, PO Box 756, Wellington 6140, New Zealand;2. Melbourne School of Population and Global Health, University of Melbourne, Parkville, VIC 3010, Australia;3. National Advisor NCD, Head of National Wellness Centre, Ministry of Health & Medical Services, Fiji;4. John A. Burns School of Medicine, University of Hawaii, University of Hawaii Cancer Center,677 Ilalo Street, Honolulu, HI 96813, United States;1. Registre des cancers du Bas-Rhin, U1113, FMTS, Université de Strasbourg, 4 rue Kirschleger, 67085 Strasbourg, France;2. Service de santé publique, Hôpitaux Universitaires de Strasbourg, 1 place de l’hôpital, 67091 Strasbourg, France;3. Registre des cancers de la Manche, Centre Hospitalier Public du Cotentin, 46 rue du Val de Saire, 50102 Cherbourg-Octeville, France;4. Registre des tumeurs de l''Hérault, Centre de Recherche, 208 rue des Apothicaires, 34298 Montpellier, France;5. Registre général des tumeurs du Calvados, Cancers & Préventions – U1086 Inserm, Centre François Baclesse, Avenue du Général Harris BP 5026, 14076 Caen, France;6. Registre des tumeurs du Doubs et du Territoire de Belfort, EA3181, Centre Hospitalier Régional Universitaire, 25030 Besançon, France;7. Registre des cancers du Tarn, 1, rue Lavazière, BP 37, 81001 Albi cedex, France;8. Institut Claudius Regaud, Centre régional de lutte contre le cancer, IUCT-O, Registre des cancers du Tarn, 31059 Toulouse, France;9. Registre des hémopathies malignes de Basse-Normandie, Unité Fonctionnelle Hospitalo-Universitaire n°0350, Centre Hospitalier Universitaire, Avenue de la Côte de Nacre, 14033 Caen, France;10. Registre des cancers de l’Isère, CHU de Grenoble, Pavillon E BP 217, 38043 Grenoble 9, France;11. Registre du cancer de la Somme, Service Épidémiologie Hygiène et Santé Publique, CHU Nord, 80054 Amiens, France;12. Service d’épidémiologie et de biostatistique, Centre Paul Strauss, 3 rue de la Porte de l’hôpital, 67065 Strasbourg, France |
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| Abstract: | Background & objectivesLiterature suggests that peri-operative blood transfusion among patients with resected colon cancer may be associated with inferior long-term survival. The study objective was to characterize this association in our population.MethodsThis is a retrospective cohort study using the population-based Ontario Cancer Registry (2002–2008). Pathology reports were obtained for a 25% random sample of all cases and constituted the study population. Log binomial regression was used to identify factors associated with transfusion. Cox proportional hazards model explored the association between transfusion and cancer specific survival (CSS) and overall survival (OS).ResultsThe study population included 7198 patients: 18% stage I, 36% stage II, 40% stage III, and 6% stage IV. Twenty-eight percent of patients were transfused. Factors independently associated with transfusion included advanced age (p < 0.001), female sex (p < 0.001), greater comorbidity (p < 0.001), more advanced disease (p < 0.001) and open surgical resection (p < 0.001). Transfusion was associated with inferior CSS (HR 1.51, 95% CI 1.38–1.65) and OS (HR 1.52, 95% CI 1.41–1.63), after adjusting for important confounders.ConclusionsPeri-operative transfusion rates among patients with colon cancer have decreased over time. Transfusion is associated with inferior long-term CSS and OS. |
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| Keywords: | Colon cancer Blood transfusion Overall survival Cancer specific survival |
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