Association of allogeneic blood transfusions and long-term survival of patients with gastric cancer after curative gastrectomy

Abstract

Introduction: The relationship between perioperative allogeneic blood transfusions and poor prognosis in patients with gastric cancer remains controversial. The aim of this study is to examine the effect of perioperative blood transfusions on long-term survival of patients undergoing curative gastric resection for gastric cancer.

Methods: Eight hundred fifty-six consecutive patients with gastric cancer who underwent curative gastrectomy (R0) from January 1, 1991 through December 31, 2002 were enrolled in this retrospective study.

Results: A multivariate overall survival analysis using Cox proportional hazard regression model revealed macroscopically infiltrative tumor, tumor infiltration of serosa, lymph node metastasis, blood transfusions (hazard ratio, 2.69), pulmonary disease, and liver dysfunction as prognostic factors for long-term survival. Blood transfusion was an independent prognostic factor at all stages of disease. Disease-specific and overall survival showed significant differences between the transfused and nontransfused groups (log-rank, P < 0.0001). Based on multivariate logistic regression analysis, the need for blood transfusion was significantly associated with advanced age (>or=65 years), long duration of operation (>or=300 min), massive blood loss (>or=1,000 ml), and anemia (Hb < 10 g/dl).

Conclusions: Allogeneic blood transfusion is an independent prognostic factor for long-term survival in gastric cancer patients.