Perioperative Blood Transfusions and Prognosis in Patients with Curatively Resected Locally Advanced Gastric Cancer

Abstract

Several reports have demonstrated an adverse effect of perioperative blood transfusions on the survival of patients with various solid tumors treated surgically. We retrospectively investigated the relationship between perioperative blood transfusions and the survival of 501 patients who underwent radical subtotal gastrectomy for locally advanced gastric cancer (stage II-IIIB) from January 1984 to December 1989. Three hundred and fifty-two patients (70.3%) received blood transfusions within the perioperative period. The transfused group included patients with tumors of larger size (5.1 vs. 4.4 cm, p = 0.001) and more advanced stage (stage IIIB: 27.6 vs. 10.7%, p = 0.0001) than the nontransfused group. Although the 5-year overall survival rate was significantly lower (52.9 vs. 66.7%, p = 0.026) in the transfused patients than the nontransfused, subgroup analysis according to the pathologic stage showed no statistically significant difference in survival in each stage between the two groups. In conclusion, we could not find any causal relationships between transfusion and prognosis in patients with curatively resected locally advanced gastric cancer. Circumstances such as advanced stage necessitating transfusions may be more important prognostic factors.

Association of Allogeneic Blood Transfusions and Long-Term Survival of Patients with Gastric Cancer after Curative Gastrectomy

“…They described that effects of blood transfusions are closely associated with other prognostic covariates and there is no prognostic significance of blood transfusions on survival time, a finding repeated in several other studies. [12][13][14] On the other hand, some studies have shown an adverse relationship. Kaneda et al 17 first proposed that blood transfusions could have a negative influence on surviving gastric cancer.…”

“…9 Blood transfusions are often needed when performing gastrectomy with radical lymph nodes dissection for gastric cancer; however, the relationship between perioperative blood transfusions and poor prognosis in patients with gastric cancer remains controversial. Although many studies do not support this relationship, [10][11][12][13][14] some studies have affirmed that it exists. [15][16][17][18][19] The aim of this study was to examine the effect of perioperative allogeneic blood transfusions on long-term survival in patients undergoing curative gastric resection for gastric cancer.…”

The Influence of Perioperative Blood Transfusion on Intrahepatic Recurrence After Curative Resection of Hepatocellular Carcinoma

“…Since that time, many other studies have reported an adverse effect of BT on the prognosis after surgery for various types of cancers (2)(3)(4)(5)(6)(7)(8)(9)(10)(11). Others have found only slight or no significant detrimental results on tumor recurrence related to BT (12)(13)(14)(15)(16)(17)(18)(19). However, only a few reports regarding the association between perioperative BT and recurrence of hepatocellular carcinoma (HCC) are available (10,11,20).…”

Immunologic Effects of Allogeneic versus Autologous Blood Transfusion in Patients Undergoing Radical Oesophagectomy

“…There have been numerous reports of autologous blood transfusion in surgery for gastric and colorectal malignancies [17,19]. Although the effects on survival remain controversial [22][23][24][25], the degree of immunosuppression undoubtedly was decreased by autologous blood transfusion in these fields of surgery [26,27]. The postoperative course of oesophageal cancer is more frequently associated with infection and recurrence than that of gastric or colorectal cancer, but the effects of autologous blood transfusion on the immune system in patients undergoing radical oesophagectomy have not been reported.…”