The prognostic role of perioperative allogeneic blood transfusions in gastric cancer patients undergoing curative resection: A systematic review and meta-analysis of non-randomized, adjusted studies

Agnes, Annamaria; Lirosi, Maria Carmen; Panunzi, Simona; Santocchi, Pietro; Persiani, Roberto; D’Ugo, Domenico

doi:10.1016/j.ejso.2018.01.006

Cited by 28 publications

(15 citation statements)

References 104 publications

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“…Anaemia may shorten survival time in cancer patients and worsen local tumour control . In addition, meta‐analyses in different types of cancer show that red cell transfusions increase the risk of tumour recurrence and decrease survival rates . Pre‐operative anaemia in patients for colorectal cancer surgery is common (30–67%) and is a cause for concern .…”

Section: Who?mentioning

confidence: 99%

Optimisation of pre‐operative anaemia in patients before elective major surgery – why, who, when and how?

2019

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Anaemia in surgical patients is a common and serious problem; around 40% of patients presenting for major surgery are anaemic. Patients with pre-operative anaemia have significantly higher rates of morbidity and mortality and are likely to be transfused red cells. In addition, red cell transfusions are independently associated with worse outcomes. Pre-optimisation of anaemia in surgical patients leads to higher pre-operative haemoglobin concentrations and less need for transfusion. Patients undergoing major surgery (defined as blood loss > 500 ml expected or possible) should be optimised if their haemoglobin concentration is less than 130 g.l À1 on screening. Detection of anaemia should follow listing for surgery as soon as possible to allow enough time for optimisation. The most common cause of pre-operative anaemia is iron deficiency, which can be treated with iron therapy. Iron clinics should be set up in either primary or secondary care to allow for optimal treatment. In this review, we present literature supporting the optimisation of pre-operative anaemia and propose a treatment algorithm.

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Section: Who?mentioning

confidence: 99%

Optimisation of pre‐operative anaemia in patients before elective major surgery – why, who, when and how?

2019

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“…Additionally, in patients with gastric cancer, overexpression of these cytokines is reportedly correlated with a poor prognosis[12,32-34]. The immunosuppression caused by BTF creates favorable conditions for tumor growth; additionally, BTF increases the risk of postoperative complications[3], which also have adverse effects on the prognosis[13].…”

Section: Mechanism Of Adverse Effect Of Btfmentioning

confidence: 99%

“…There are lasting discussions and controversies about whether IBL or BTF has adverse effects on the prognosis in patients with gastric cancer[1-3]. Patients requiring BTF often have severe illness, advanced cancer, a poor general condition, and a higher prevalence of comorbidities, and these confounding factors themselves induce postoperative complications, surgical death, and a worse prognosis[4-6].…”

Section: Introductionmentioning

confidence: 99%

Long-lasting discussion: Adverse effects of intraoperative blood loss and allogeneic transfusion on prognosis of patients with gastric cancer

Nakanishi

Kanda

Kodera

2019

WJG

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Gastrectomy with radical lymph node dissection is the most promising treatment avenue for patients with gastric cancer. However, this procedure sometimes induces excessive intraoperative blood loss and requires perioperative allogeneic blood transfusion. There are lasting discussions and controversies about whether intraoperative blood loss or perioperative blood transfusion has adverse effects on the prognosis in patients with gastric cancer. We reviewed laboratory and clinical evidence of these associations in patients with gastric cancer. A large amount of clinical evidence supports the correlation between excessive intraoperative blood loss and adverse effects on the prognosis. The laboratory evidence revealed three possible causes of such adverse effects: anti-tumor immunosuppression, unfavorable postoperative conditions, and peritoneal recurrence by spillage of cancer cells into the pelvis. Several systematic reviews and meta-analyses have suggested the adverse effects of perioperative blood transfusions on prognostic parameters such as all-cause mortality, recurrence, and postoperative complications. There are two possible causes of adverse effects of blood transfusions on the prognosis: Anti-tumor immunosuppression and patient-related confounding factors ( e.g ., preoperative anemia). These factors are associated with a worse prognosis and higher requirement for perioperative blood transfusions. Surgeons should make efforts to minimize intraoperative blood loss and transfusions during gastric cancer surgery to improve patients’ prognosis.

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“…Exopolysaccharides from an Ophiopogon japonicus endophyte inhibit proliferation and migration in MC-4 human gastric cancer cells japonicus is an evergreen, sod-forming perennial plant that is widely used in traditional Chinese medicine (TCM). The root tuber is the medicinal part of O. japonicus and exerts its antitumor activity by enhancing the immune response of the body against cancer (13)(14)(15). Extensive studies have revealed that the major active ingredients in O. japonicus are polysaccharides, which can not only reduce the toxicity caused by chemotherapy drugs, but also possess synergistic antitumor activity (16,17).…”

Section: Original Articlementioning

confidence: 99%

Exopolysaccharides from an Ophiopogon japonicus endophyte inhibit proliferation and migration in MC-4 human gastric cancer cells

Xu¹,

Yang²,

Yang³

et al. 2018

Transl. Cancer Res

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Background: Recently, natural products have gained increasing attention. Endophytic bacteria represent a source of natural anticancer products, and are well-known for producing diverse bioactive anti-cancer compounds. Herein, we investigated the antitumor activity of exopolysaccharides (EPSs) extracted from endophytes in Ophiopogon japonicus.Methods: The endophyte bacterium MD4 was isolated from O. japonicus. To identify MD4, a partial sequence of 16S rDNA was analyzed. The phenol-sulfuric acid method was used to measure the EPSs concentration. Cell viability was tested by the MTT assay to quantify the EPS cytotoxicity effect. Wounding healing, gelatin zymography, and ELISA were used to measure cell migration ability.Results: MD4 was identified as a Staphylococcus sp. with 99% similarity. The results of the phenol sulfuric acid method showed that the purified EPS concentration from MD4 was 28.068 μg/μL. There was a concentration-dependent cytotoxic effect of MD4-EPS on MC-4 cells, with IC50 values of 0.891 μg/μL.The results of the MTT assay showed that MD4-EPS effectively inhibited the migration of MC-4 cells as the concentration increased. The gelatin zymography analysis showed that the enzymatic activities of the migration-related MMP2 and MMP9 proteins decreased after EPS treatment. Furthermore, the protein secretion levels of MMP2 and MMP9 after MD4-EPS treatment were significantly lower than those in the control and PBS groups.Conclusions: Our results demonstrate that the EPSs derived from the MD4 endophyte of O. japonicus acted as natural antitumor agents to inhibit the migration of gastric cancer cells.

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The prognostic role of perioperative allogeneic blood transfusions in gastric cancer patients undergoing curative resection: A systematic review and meta-analysis of non-randomized, adjusted studies

Cited by 28 publications

References 104 publications

Optimisation of pre‐operative anaemia in patients before elective major surgery – why, who, when and how?

Optimisation of pre‐operative anaemia in patients before elective major surgery – why, who, when and how?

Long-lasting discussion: Adverse effects of intraoperative blood loss and allogeneic transfusion on prognosis of patients with gastric cancer

Exopolysaccharides from an Ophiopogon japonicus endophyte inhibit proliferation and migration in MC-4 human gastric cancer cells

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