Do perioperative blood transfusions influence prognosis of gastric cancer patients? Analysis of 927 patients and interactions with splenectomy.
BACKGROUND
This study was to assess the influence of perioperative blood transfusions on the prognosis of patients undergoing a potentially curative resection for gastric cancer and to investigate the interaction between transfusions and splenectomy.


METHODS
Between January 1990 and December 2005, 927 patients from 6 Italian tertiary referral centers underwent curative resections for gastric cancer. Clinical and pathologic variables were prospectively collected. The influence of perioperative blood transfusions on survival were evaluated by univariate and multivariate analysis. Moreover, the influence of splenectomy both in transfused and nontransfused patients undergoing total gastrectomy was also evaluated.


RESULTS
The overall 5-year survival was 54.6%. The 5-year survival rate in transfused patients (n = 327) was 50.6% compared with 56.6% in nontransfused patients (n = 600) (P = .094). In the subgroup of patients who underwent total gastrectomy with spleen preservation (n = 209), 5-year survival rate was 46% and 51.4% in transfused and nontransfused patients, respectively (P = .418); those who underwent total gastrectomy with splenectomy (n = 199) presented a 5-year survival rate of 45% in transfused group compared with 39.1% in nontransfused patients (P = .571).


CONCLUSIONS
Our study indicates a slightly, but not significantly, negative effect of allogeneic blood transfusion on prognosis of gastric cancer patients. In the subgroup of patients who underwent total gastrectomy, splenectomy seems to invert this mild effect, with a positive influence on overall survival.
Department of Digestive Surgery, Catholic University of Rome, Rome, Italy. fpacelli@rm.unicatt.it
Fabio
F
Pacelli
Fausto
F
Rosa
Daniele
D
Marrelli
Corrado
C
Pedrazzani
Maurizio
M
Bossola
Marco
M
Zoccali
Alberto
A
Marchet
Mariantonietta
M
Di Cosmo
Claudia
C
Roata
Luigina
L
Graziosi
Emanuel
E
Cavazzoni
Marcello
M
Covino
Domenico
D
D'Ugo
Franco
F
Roviello
Donato
D
Nitti
Giovanni Battista
GB
Doglietto
D000230:Adenocarcinoma / Q000473:pathology / Q000601:surgery*; D000368:Aged; D001803:Blood Transfusion; D005260:Female; D006801:Humans; D008297:Male; D019990:Perioperative Care; D011379:Prognosis; D012189:Retrospective Studies; D013156:Splenectomy; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*; D015996:Survival Rate