Incidence pronostique de la transfusion sanguine chez 753 malades opérés d'un adénocarcinome colorectal

: Do transfusions have a deleterious effect on the survival after surgery for colorectal carcinoma (CRC)? Among 1,221 patients operated on for a CRC between 1969 and 1988, 753 patients having undergone a curative surgical procedure with a follow-up of at least six months were evaluated retrospectively. 134 patients (17.2%) did not receive any transfusion; the others 619 (82.80%) received transfusions including 150 with packed red blood cells only. Transfused and non transfused patients were compared. Among the classical indicators for disease free survival, the only valuable parameter was the pathological classification, but it was not discriminant between transfused and non transfused patients. Prognostic value of transfusions were evaluated with regard of the components and the quantity of transfused items, the time of transfusions (either per- or perioperative), the surgical procedures and the tumor location on colon and rectum. The 5 years survival of transfused patients was less than for non transfused patients (56.3% versus 61.7%, p > 0.05 NS), but only the transfusions of more than 5 packed red blood cells worsened significantly the prognostic. (5 years chi 2 = 5.7; p < 0.02). Adjustments with pathologic analysis and time evolutive indications for transfusions did not alter those results. These results point the fact that transfusions could influence survival after surgery for CRC and stress us to limit reasonably transfusions.