Impact of perioperative blood transfusion on immune function and prognosis in colorectal cancer patients

Objective: To investigate the impacts of perioperative blood transfusion on the immune function and prognosis in colorectal cancer (CC) patients. Methods: A retrospective analysis was conducted in 1404 CC patients, including 1223 sporadic colorectal cancer (SCC) patients and 181 hereditary colorectal cancer (HCC) patients. Among them, 701 SCC and 102 HCC patients received perioperative blood transfusion. The amount of T lymphocyte subsets and natural killer (NK) cells was measured. All patients received a 10-year follow-up and relapse, metastasis and curative conditions were recorded. Results: In SCC group, mortality, local recurrence and distant metastasis rate of transfused patients were significantly higher than non-transfused patients (all P < 0.05). In HCC group, mortality was apparently higher in transfused patients than non-transfused patients (P=0.002). SCC patients transfused with >= 3 U of blood had significantly higher mortality than patients transfused with <3 U (P = 0.006). The amount of T lymphocyte subsets and NK cells showed statistical differences before and after perioperative blood transfusion in SCC and HCC patients (all P < 0.05). Also, there existed statistical differences in CD4+/CD8+ ratio among SCC patients before and after the perioperative blood transfusion (P < 0.05). CC patients who received perioperative blood transfusion had markedly lower 10-year survival rates as compared with those who did not receive (both P < 0.05). SCC patients transfused with >= 3 U of blood had remarkably lower survival rates compared with SCC patients transfused with <3 U (P = 0.002). Conclusions: Perioperative blood transfusion could impact immune function, increased postoperative mortality, local recurrence rate and distant metastasis rate in CC patients; and survival rate of CC patients is negatively related to blood transfusion volume. (C) 2016 Published by Elsevier Ltd.