PERIOPERATIVE BLOOD-TRANSFUSION AND OUTCOME AFTER RESECTION FOR COLORECTAL-CARCINOMA

The degree of immunomodulation by perioperative blood transfusion and its effect on oncological surgery remain controversial. A major proble m with previous clinical studies has been the inadequate patient popul ation in each and the presence of confounding variables. To resolve so me of the controversy, all studies published between 1982 and 1990 wer e reviewed using the statistical method of Mantel-Haentszel-Peto to de termine a cumulative estimate of the direction and magnitude of this a ssociation. Some 20 papers were included in the analysis, representing 5236 patients. The cumulative odds ratios (95 per cent confidence int erval) of disease recurrence, death from cancer and death from any cau se were 1.80 (1.30-2.51), 1.76 (1.15-2.66) and 1.63 (1.12-2.38) respec tively. These results support the hypothesis that perioperative blood transfusion is associated with an increased risk of recurrence of colo rectal carcinoma and death from this malignancy.