Journal of Hematology & Thromboembolic Diseases
Open Access

Abstract

Impact of Preoperative Anemia and Blood Transfusion on Long-Term Survival Outcomes in Colorectal Cancer Surgery

Gupta Abhishek

Background: Perioperative anemia and blood transfusion are closely intertwined factors, exerting adverse effects on the survival outcomes of Colorectal Cancer (CRC) patients. Despite prevailing reliance on transfusion for anemia treatment in several countries, questions persist regarding the combined impact of preoperative anemia and postoperative anemia, as well as preoperative anemia and blood transfusion, on the long-term outcomes of CRC patients. Methods: A retrospective propensity-score-matched analysis was conducted on 100 CRC patients undergoing elective surgery between January 1, 2022 and December 31, 2023. Novel models were constructed using Kaplan-Meier survival analysis and univariable and multivariable Cox proportional hazards models, following propensity-score matching. Prognostic factors for Overall Survival (OS) and Disease-Free Survival (DFS) were examined through univariate and multivariate Cox regression analysis. Results: Among the CRC patients, 24.3% presented with preoperative anemia and 75.7% did not. After matching, 50 patients remained in each group. In the preoperative anemia and postoperative anemia model, both were identified as independent risk factors for OS (HR, 1.202; 95% CI, 1.043-1.385; P=0.011) and DFS (HR, 1.210; 95% CI, 1.050-1.395; P=0.008). In the preoperative anemia and transfusion model, preoperative anemia and transfusion emerged as the most hazardous independent prognostic factor for OS (HR: 95%; P<0.001) and DFS (HR: 95%; P<0.001). Among patients with preoperative anemia, those receiving transfusion exhibited worse OS and DFS compared to non-transfused counterparts (P=0.026 in OS; P=0.037 in DFS). Conclusion: Preoperative anemia and blood transfusion pose a heightened risk to OS and DFS in CRC surgery patients, with the detrimental impact of transfusion surpassing that of postoperative anemia. These findings underscore the importance of timely prevention and treatment of anemia, advocating for anemia tolerance while exercising caution in the use of blood transfusion for CRC patients.

Published Date: 2025-02-21;