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. 2024 Apr 30;15(2):555-565.
doi: 10.21037/jgo-23-906. Epub 2024 Apr 28.

Effect of perioperative blood transfusion on complications and prognosis after radical gastrectomy in elderly patients: a retrospective study of 1,666 cases

Jinqiang Liu #  1 , Kunli Du #  1 , Rui Zhang #  1 , Wei Zhou  1 , Gaozan Zheng  1 , Pengfei Wang  1 , Jianyong Zheng  1 , Fan Feng  1
Affiliations

Effect of perioperative blood transfusion on complications and prognosis after radical gastrectomy in elderly patients: a retrospective study of 1,666 cases

Jinqiang Liu et al. J Gastrointest Oncol. .

Abstract

Background: Multiple studies have examined the effect of perioperative blood transfusion (BTF) on postoperative complications and the prognosis of gastric cancer patients, but the conclusions remain controversial, and few studies related to elderly patients are present. This study sought to examine the effect of perioperative BTF on postoperative complications and the prognosis of elderly patients who underwent radical gastrectomy.

Methods: The clinical data of 1,666 elderly patients (aged ≥60 years) at Xijing Hospital from October 2013 to October 2021 were retrospectively analyzed. The patients were stratified into the perioperative BTF group and the perioperative non-BTF group. The clinicopathological characteristics, postoperative complications, and long-term prognoses of the patients were compared.

Results: There were significant differences in terms of sex, tumor location, tumor size, gastrectomy range, tumor differentiation, T stage, N stage, tumor-node-metastasis (TNM) stage, preoperative anemia, and intraoperative blood loss between the two groups (P<0.05). The incidence of postoperative fever in the BTF group was significantly higher than that in the non-BTF group (31.6% vs. 15.4%, P<0.001), but there were no significant differences in the other complications between the two groups (P>0.05). The survival analysis showed that in stage III patients, the prognosis of the BTF group was inferior to that of the non-BTF group [the 3-year overall survival (OS) rates of the groups were 33.7% vs. 47.9% respectively, P<0.001], while there was no significant difference between the two groups among the stage I and stage II patients (P>0.05). There was no significant difference in the prognosis of patients with different transfusion times (preoperative/intraoperative/postoperative) (P>0.05). The multivariate analysis indicated that perioperative BTF was not an independent risk factor for prognosis in elderly patients with gastric cancer overall or elderly patients with gastric cancer in stage III (P>0.05).

Conclusions: Perioperative BTF may elevate the incidence of fever but has no significant effect on other complications in elderly patients after radical gastrectomy. Perioperative BTF is not an independent risk factor affecting the postoperative prognosis of elderly patients with gastric cancer.

Keywords: Perioperative blood transfusion (perioperative BTF); complications; elderly; gastrectomy; prognosis.

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Conflict of interest statement

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://jgo.amegroups.com/article/view/10.21037/jgo-23-906/coif). The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Flow chart of data sources and screening of cases.
Figure 2
Figure 2
OS of patients stratified by BTF group and non-BTF group. BTF, blood transfusion; OS, overall survival.
Figure 3
Figure 3
Comparison of OS according to perioperative BTF in the same tumor stage. TNM, tumor-node-metastasis; BTF, blood transfusion; OS, overall survival.
Figure 4
Figure 4
OS of patients compared by preoperative, intraoperative, and postoperative BTF. BTF, blood transfusion; OS, overall survival.
See this image and copyright information in PMC

Comment in

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