title: Impact of Peri-Operative Anemia and Blood Transfusions in Patients with Gastric Cancer Receiving Gastrectomy.
abstract: BACKGROUND
  Potential disadvantages of blood transfusion during curative gastrectomy for gastric cancer have been reported, and the role of peri-operative transfusions remains to be ascertained. Thus, the aim of our study was to survey its impact in patients with gastric cancer undergoinging gastrectomy.
  
  
  METHODS
  Clinical data of patients receiving curative gastrectomy at Far Eastern Memorial Hospital were obtained. Findings for pre-operative anemia states, pre-, peri- and post-operative transfusion of red blood cell (RBC) products as well as post-operative complication events were collected for univariate analysis.
  
  
  RESULTS
  A total of 116 patients with gastric cancer received gastrectomy at Far Eastern Memorial Hospital from 2011 to 2014. Both pre-operative and intra- and post-operative transfusion of RBC products were markedly associated with post-operative infectious events (OR: 3.70, 95% CI: 1.43-9.58, P=0.002; OR: 8.20, 95% CI: 3.11-22.62, P<0.001, respectively). In addition, peri- and post-operative RBC transfusion was significantly associated with prolonged hospital stay from admission to discharge (OR: 8.66, 95% CI: 1.73-83.00, P=0.002) and post-operative acute renal failure (OR: 19.69, 95% CI: 2.66-854.56, P<0.001). Also, the overall survival was seemingly decreased by peri-operative RBC transfusion in our gastric cancer cases (P=0.078).
  
  
  CONCLUSIONS
  Our survey indicated that peri-operative RBC transfusion could increase the risk of infectious events and acute renal failure post curative gastrectomy as well as worsen the overall survival in gastric cancer cases. Hence, unnecessary blood transfusion before, during and after curative gastrectomy should be avoided in patients with gastric cancer.
authors.affiliation: Department of Clinical Pathology, Far Eastern Memorial Hospital, New Taipei, Taiwan E-mail : jacpha@mail.femh.org.tw.
authors.forename: Chih-Chun
authors.initials: CC
authors.lastname: Chang
authors.forename: Jen-Tang
authors.initials: JT
authors.lastname: Sun
authors.forename: Jing-Yuan
authors.initials: JY
authors.lastname: Chen
authors.forename: Yi-Ting
authors.initials: YT
authors.lastname: Chen
authors.forename: Pei-Yu
authors.initials: PY
authors.lastname: Li
authors.forename: Tai-Chen
authors.initials: TC
authors.lastname: Lee
authors.forename: Ming-Jang
authors.initials: MJ
authors.lastname: Su
authors.forename: Jiann-Ming
authors.initials: JM
authors.lastname: Wu
authors.forename: Tzung-Hai
authors.initials: TH
authors.lastname: Yen
authors.forename: Fang-Yeh
authors.initials: FY
authors.lastname: Chu
mesh_terms: D000230:Adenocarcinoma / Q000150:complications / Q000473:pathology / Q000601:surgery*; D000368:Aged; D000740:Anemia / Q000209:etiology* / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy / Q000009:adverse effects*; D005770:Gastrointestinal Neoplasms / Q000150:complications / Q000473:pathology / Q000601:surgery*; D046152:Gastrointestinal Stromal Tumors / Q000150:complications / Q000473:pathology / Q000601:surgery*; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011183:Postoperative Complications; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000150:complications / Q000473:pathology / Q000601:surgery*; D015996:Survival Rate; D065227:Transfusion Reaction