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Evidence summaries

Erythropoeitin for Reducing Allogeneic Blood Transfusions in Colorectal Cancer Surgery

Pre and peri-operative erythropoietin use might possibly not decrease blood transfusions in colorectal cancer surgery, although the evidence is insufficient. Level of evidence: "D"

A Cochrane review [Abstract] 1 included 4 studies with a total of 462 subjects. There were no statistically significant differences in the proportion of patients transfused between the erythropoietin group and control group (RR 0.92, 95% CI 0.65 to 1.31, 3 studies). 1 of the studies showed a small difference in the median number of units transfused per patient favouring treatment. There were no significant differences in post-operative mortality (RR 2.12, 95% CI 0.59 to 7.65; 2 studies) or thrombotic events (RR 1.71, 95% CI 0.41 to 7.08) between the treatment and control groups. No included study evaluated recurrences, survival, or quality of life.

Comment: The quality of evidence is downgraded by study quality (inadequate or unclear allocation concealment and inadequate intention-to-treat adherence), by indirectness (short duration and low dose of intervention) and by imprecise results (limited study size for each comparison).

    References

    • Devon KM, McLeod RS. Pre and peri-operative erythropoietin for reducing allogeneic blood transfusions in colorectal cancer surgery. Cochrane Database Syst Rev 2009 Jan 21;(1):CD007148. [PubMed]

Primary/Secondary Keywords