Programmpunkt

15:25

Titel: Influence of anemia and blood transfusions on the long-term survival of patients after elective colon surgery for colon carcinomas
ID: VS-8-3
Art: Abstractvortrag
Redezeit: 10 + 5 min
Session:
Sektion Hämotherapie
VS-8

Referent: Christian Hönemann (Vechta)


Abstract - Text

Offenlegung Interessenkonflikt:

Dr. Hönemann received financial support for teaching and travelling from Vifor Pharma GmbH, Munich, Germany

Methods

The Kaplan-Meier analysis is used to determine the influence of both preoperative anemia and FRC on the LTE. In addition, a Cox regression analysis is used to examine the factors age, sex, Hb value, tumor size (T), lymph node status (N), metastases (M), grading (G), Revised Cardiac Risc Index (RCRI), obtained red cell concentrates (FRCs) and blood products (Bp) as well as the length of hospital stay in their influence on the LTE. Furthermore, age, sex, Hb-value, T, N, M, G, RCRI, pneumonia postoperatively, duration of surgery, duration of hospital stay and postoperative ventilation duration are analysed in a multinomial logistic regression analysis with regard to a significant correlation with transfusion demand.

Results

It is found that preoperatively anemic patients received more FRC's than non-anemic patients. The RCRI is worse in transfused patients than in non-transfused patients (68% 3-year survival rate in patients transfused with 1-2 Eks vs. 82% in non-transfused patients). FRC's, not other blood products, are the main influencing factor. In the Cox regression, RBC's do not appear as significant predictors for a worse LTE, but T, N, M and the RCRI do. Related to the transfusion requirement are the Hb value, an extended operation time and a longer hospital stay. Preoperative anemia is not significantly associated with reduced LTE, but there is a tendency.

Background

Colorectal carcinoma (CRC) is one of the most common cancers worldwide. In Germany, approximately 30,000 deaths per year are attributable to CRC. Often patients also suffer from anemia, which is partly treated with the FRC blood transfusions (FRC). The effect of FRC has been discussed and investigated since the 1980s, as poor long-term survival (LTE) of patients after FRC has been observed.

Conclusion

The results suggest that FRC might be associated with reduced LTE. However, it can be assumed that the general conditions of FRC play a decisive role. FRC should also be used restrictively because of transfusion risks and costs. Preoperative anaemia increases the risk of FRC and should be detected and treated early. The RCRI can be used to identify risk patients. A detailed analysis of the individual components involved would be interesting.