Intervention Review

Pre and peri-operative erythropoeitin for reducing allogeneic blood transfusions in colorectal cancer surgery.

  1. Karen M Devon1,*,
  2. Robin S McLeod2

Editorial Group: Cochrane Colorectal Cancer Group

Published Online: 21 JAN 2009

Assessed as up-to-date: 30 OCT 2008

DOI: 10.1002/14651858.CD007148.pub2

How to Cite

Devon KM, McLeod RS. Pre and peri-operative erythropoeitin for reducing allogeneic blood transfusions in colorectal cancer surgery.. Cochrane Database of Systematic Reviews 2009, Issue 1. Art. No.: CD007148. DOI: 10.1002/14651858.CD007148.pub2.

Author Information

  1. 1

    University of Toronto, Mount Sinai Hospital, Department of Surgery, Toronto, Ontario, Canada

  2. 2

    Mount Sinai Hospital, Division of General Surgery, Toronto, Ontario, Canada

*Karen M Devon, Department of Surgery, University of Toronto, Mount Sinai Hospital, 600 University Ave. Suite 449, c/o Dr. R.S. McLeod, Toronto, Ontario, Canada.

Publication History

  1. Publication Status: New
  2. Published Online: 21 JAN 2009




  1. Top of page
  2. Abstract
  3. Plain language summary
  4. アブストラクト
  5. 摘要


Patients with colorectal cancer are frequently anaemic and many receive allogeneic red blood cell transfusions peri and post-operatively. Transfusions are accompanied by complications and may increase the rate of recurrence in patients who have a colorectal resection. Recombinant erythropoietin was first used in dialysis patients and more recently in orthopedic surgery to facilitate autologous transfusions. Erythropoietin levels are thought to be lower in cancer patients and erythropoietin is widely used in chemotherapy to treat anaemia and improve quality of life. There may be adverse events associated with its use. Several studies have investigated erythropoietin in colorectal cancer surgery.


The primary objective of this systematic review was to evaluate the efficacy of erythropoietin pre and peri-operatively, in reducing allogeneic blood transfusions in patients undergoing colorectal cancer surgery. Secondary objectives were to determine whether pre and peri-operative erythropoietin improves hematologic parameters (hemoglobin, hematocrit and reticulocyte count), quality of life, recurrence rate, and survival, without increasing the occurrence of thrombotic events and the peri-operative mortality.

Search methods

A literature search was performed using MEDLINE, EMBASE, abstracts from the annual meetings of the American Society of Clinical Oncology and the American Society of Colon and Rectal Surgeons until May 2008.

Selection criteria

Randomized controlled trials of erythropoietin versus placebo or no treatment/standard of care were eligible for inclusion. The study must have reported one of the primary or secondary outcomes and included anaemic patients undergoing surgery for colorectal cancer.

Data collection and analysis

The methodological quality of the trials was assessed using the information provided. Data were extracted and effect sizes were estimated and reported as relative risks(RR) and mean differences (MD) as appropriate.

Main results

Four eligible studies were identified of ten retrieved in full. There were no statistically significant differences in the proportion of patients transfused between the erythropoietin group and control group. One of the studies showed a small difference in the median number of units transfused per patient favouring treatment. Reporting of hematologic parameters was varied however, there is no evidence for clinically significant changes. There were no significant differences in post-operative mortality or thrombotic events between groups. No included study evaluated recurrences, survival, or quality of life. Studies were of fair methodologic quality and the overall sample size was small therefore results should be interpreted with caution.

Authors' conclusions

There is no sufficient evidence to date to recommend pre and peri-operative erythropoietin use in colorectal cancer surgery.


Plain language summary

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. アブストラクト
  5. 摘要

The use of erythropoietin improve anaemia and reduces blood transfusions in surgery for cancer of the large bowel.

Patients with cancer of the large bowel are often anaemic and sometimes receive transfusions which may be harmful. The medication erythropoietin can be used to increase hemoglobin levels in a variety of situations and several studies have looked at this in patients who have surgery for their large bowel cancer. This systematic review of four studies found there is insufficient evidence to support the use of erythropoietin in the preoperative and post-operative period for improving anaemia and decreasing blood transfusions. There was also no evidence that the medication was the cause of increased complications or deaths. Future studies or erythropoietin in large bowel cancer surgery should increase the dose or duration of treatment.



  1. Top of page
  2. Abstract
  3. Plain language summary
  4. アブストラクト
  5. 摘要







2008年5月までのMEDLINE、EMBASE、ならびにAmerican Society of Clinical OncologyおよびAmerican Society of Colon and Rectal Surgeonsの年会の抄録を用いて文献検索を行った。










監  訳: 柴田 実,2009.5.13

実施組織: 厚生労働省委託事業によりMindsが実施した。

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  1. Top of page
  2. Abstract
  3. Plain language summary
  4. アブストラクト
  5. 摘要


在進行大腸直腸癌手術之前和之中使用紅血球生成素來降低異體輸血(allogeneic blood transfusions)需求



本研究的主要目的在於系統性的評估在手術前和手術中使用紅血球生成素對於降低大腸直腸癌手術中患者所需的異體輸血量的功效,本研究的次要目的是希望能夠瞭解是否在手術前或手術中使用紅血球生成素可以改善相關血液參數(例如血紅素(hemoglobin)、血球容積比(hematocrit)和網狀紅血球計數(reticulocyte count))、生活品質、復發率和存活率,並且不會增加血栓事件的發生率和手術中死亡率


本研究係針對MEDLINE、EMBASE資料庫和American Society of Clinical Oncology以及American Society of Colon and Rectal Surgeons 的定期會議摘要進行搜尋,檢索時間到2008年5月










此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌