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Risk factors for blood transfusion and its prognostic implications in curative gastrectomy for gastric cancer
BACKGROUND: Gastric cancer (GC) is still a prevalent neoplasm around the world and its main treatment modality is surgical resection. The need for perioperative blood transfusions is frequent, and there is a long-lasting debate regarding its impact on survival. AIM: To evaluate the factors related t...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Baishideng Publishing Group Inc
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10190727/ https://www.ncbi.nlm.nih.gov/pubmed/37206080 http://dx.doi.org/10.4240/wjgs.v15.i4.643 |
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author | Kawakami, Lucas Eiki Bonomi, Pedro Barzan Pereira, Marina Alessandra Carvalho, Fabrício Oliveira Ribeiro Jr, Ulysses Zilberstein, Bruno Sampaio, Luciana Ribeiro Carneiro-D'Albuquerque, Luiz Augusto Ramos, Marcus Fernando Kodama Pertille |
author_facet | Kawakami, Lucas Eiki Bonomi, Pedro Barzan Pereira, Marina Alessandra Carvalho, Fabrício Oliveira Ribeiro Jr, Ulysses Zilberstein, Bruno Sampaio, Luciana Ribeiro Carneiro-D'Albuquerque, Luiz Augusto Ramos, Marcus Fernando Kodama Pertille |
author_sort | Kawakami, Lucas Eiki |
collection | PubMed |
description | BACKGROUND: Gastric cancer (GC) is still a prevalent neoplasm around the world and its main treatment modality is surgical resection. The need for perioperative blood transfusions is frequent, and there is a long-lasting debate regarding its impact on survival. AIM: To evaluate the factors related to the risk of receiving red blood cell (RBC) transfusion and its influence on surgical and survival outcomes of patients with GC. METHODS: Patients who underwent curative resection for primary gastric adenocarcinoma at our Institute between 2009 and 2021 were retrospectively evaluated. Clinicopathological and surgical characteristics data were collected. The patients were divided into transfusion and non-transfusion groups for analysis. RESULTS: A total of 718 patients were included, and 189 (26.3%) patients received perioperative RBC transfusion (23 intraoperatively, 133 postoperatively, and 33 in both periods). Patients in the RBC transfusions group were older (P < 0.001), and had more comorbidities (P = 0.014), American Society of Anesthesiologists classification III/IV (P < 0.001), and lower preoperative hemoglobin (P < 0.001) and albumin levels (P < 0.001). Larger tumors (P < 0.001) and advanced tumor node metastasis stage (P < 0.001) were also associated with the RBC transfusion group. The rates of postoperative complications (POC) and 30-d and 90-d mortality were significantly higher in the RBC transfusion group than in the non-transfusion group. Lower hemoglobin and albumin levels, total gastrectomy, open surgery, and the occurrence of POC were factors associated with the RBC transfusion. Survival analysis demonstrated that the RBC transfusions group had worse disease-free survival (DFS) and overall survival (OS) compared with patients who did not receive transfusion (P < 0.001 for both). In multivariate analysis, RBC transfusion, major POC, pT3/T4 category, pN+, D1 lymphadenectomy, and total gastrectomy were independent risk factors related to worse DFS and OS. CONCLUSION: Perioperative RBC transfusion is associated with worse clinical conditions and more advanced tumors. Further, it is an independent factor related to worse survival in the curative intent gastrectomy setting. |
format | Online Article Text |
id | pubmed-10190727 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Baishideng Publishing Group Inc |
record_format | MEDLINE/PubMed |
spelling | pubmed-101907272023-05-18 Risk factors for blood transfusion and its prognostic implications in curative gastrectomy for gastric cancer Kawakami, Lucas Eiki Bonomi, Pedro Barzan Pereira, Marina Alessandra Carvalho, Fabrício Oliveira Ribeiro Jr, Ulysses Zilberstein, Bruno Sampaio, Luciana Ribeiro Carneiro-D'Albuquerque, Luiz Augusto Ramos, Marcus Fernando Kodama Pertille World J Gastrointest Surg Retrospective Study BACKGROUND: Gastric cancer (GC) is still a prevalent neoplasm around the world and its main treatment modality is surgical resection. The need for perioperative blood transfusions is frequent, and there is a long-lasting debate regarding its impact on survival. AIM: To evaluate the factors related to the risk of receiving red blood cell (RBC) transfusion and its influence on surgical and survival outcomes of patients with GC. METHODS: Patients who underwent curative resection for primary gastric adenocarcinoma at our Institute between 2009 and 2021 were retrospectively evaluated. Clinicopathological and surgical characteristics data were collected. The patients were divided into transfusion and non-transfusion groups for analysis. RESULTS: A total of 718 patients were included, and 189 (26.3%) patients received perioperative RBC transfusion (23 intraoperatively, 133 postoperatively, and 33 in both periods). Patients in the RBC transfusions group were older (P < 0.001), and had more comorbidities (P = 0.014), American Society of Anesthesiologists classification III/IV (P < 0.001), and lower preoperative hemoglobin (P < 0.001) and albumin levels (P < 0.001). Larger tumors (P < 0.001) and advanced tumor node metastasis stage (P < 0.001) were also associated with the RBC transfusion group. The rates of postoperative complications (POC) and 30-d and 90-d mortality were significantly higher in the RBC transfusion group than in the non-transfusion group. Lower hemoglobin and albumin levels, total gastrectomy, open surgery, and the occurrence of POC were factors associated with the RBC transfusion. Survival analysis demonstrated that the RBC transfusions group had worse disease-free survival (DFS) and overall survival (OS) compared with patients who did not receive transfusion (P < 0.001 for both). In multivariate analysis, RBC transfusion, major POC, pT3/T4 category, pN+, D1 lymphadenectomy, and total gastrectomy were independent risk factors related to worse DFS and OS. CONCLUSION: Perioperative RBC transfusion is associated with worse clinical conditions and more advanced tumors. Further, it is an independent factor related to worse survival in the curative intent gastrectomy setting. Baishideng Publishing Group Inc 2023-04-27 2023-04-27 /pmc/articles/PMC10190727/ /pubmed/37206080 http://dx.doi.org/10.4240/wjgs.v15.i4.643 Text en ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved. https://creativecommons.org/licenses/by-nc/4.0/This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/ |
spellingShingle | Retrospective Study Kawakami, Lucas Eiki Bonomi, Pedro Barzan Pereira, Marina Alessandra Carvalho, Fabrício Oliveira Ribeiro Jr, Ulysses Zilberstein, Bruno Sampaio, Luciana Ribeiro Carneiro-D'Albuquerque, Luiz Augusto Ramos, Marcus Fernando Kodama Pertille Risk factors for blood transfusion and its prognostic implications in curative gastrectomy for gastric cancer |
title | Risk factors for blood transfusion and its prognostic implications in curative gastrectomy for gastric cancer |
title_full | Risk factors for blood transfusion and its prognostic implications in curative gastrectomy for gastric cancer |
title_fullStr | Risk factors for blood transfusion and its prognostic implications in curative gastrectomy for gastric cancer |
title_full_unstemmed | Risk factors for blood transfusion and its prognostic implications in curative gastrectomy for gastric cancer |
title_short | Risk factors for blood transfusion and its prognostic implications in curative gastrectomy for gastric cancer |
title_sort | risk factors for blood transfusion and its prognostic implications in curative gastrectomy for gastric cancer |
topic | Retrospective Study |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10190727/ https://www.ncbi.nlm.nih.gov/pubmed/37206080 http://dx.doi.org/10.4240/wjgs.v15.i4.643 |
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