Does Perioperative Blood Transfusion Influence Long-Term Prognosis of Gastric Cancer?

We analyzed the influence of packed red bloodcell (PRBC) transfusions on the prognosis of 163patients with gastric adenocarcinoma undergoing subtotalgastrectomy with a curative intention. Over a period of 15 years, our department admitted 505patients with gastric adenocarcinoma, with curativesubtotal gastrectomy being performed in 167 cases. Meanage was 62.2 years (range: 30–87); there was apredominance of males (104 cases; 63.8%). Excluding the fourpatients who died in the immediate postoperative period(first 30 days), the remaining 163 were reviewed twiceyearly in our department until either they died or the study ended. Follow-up averaged49.5 months, with a median of 36 months. Sixty-nine(42.3%) of the 163 patients received transfusions ofPRBC. On correlating the variables with the transfusion, we found a statistical significance onlybetween the rate of transfusion and patient age over 63years (P < 0.01), with an evolution time of less thanthree months (P < 0.05) and in tumors of >4 cm (P< 0.05). The five-year survival rate of thenontransfusion patients was 56.9% and of the transfusionpatients 40%, with statistically significant differences(P = 0.0132). On studying patients according to tumor stage, we found that blood transfusion had astatistically significant influence on prognosis only inpatients with tumor stage III (P = 0.0051). In theunivariate analysis of the remaining variablescollected, the existence of abdominal tumor (P = 0.0307),tumor size (P = 0.00001), degree of involvement of thegastric wall (P = 0.00001), lymph node involvement (P =0.00001) and tumor stage (P = 0.00001) revealed a statistically significant influence onprognosis. If we apply Cox's regression model to thevariables that in the univariate analysis had astatistically significant influence on prognosis, wefound that only tumor size and stage were independentpredictors of survival. In our experience, PRBCtransfusion does not influence the long-term survival ofpatients with resected gastric adenocarcinoma.