Adverse affect of blood transfusions on survival of patients with gastric cancer

Kaneda, Miyuki; Horimi, Tadashi; Ninomiya, Motoki; Nagae, Shonosuke; Mukai, Kota; Takeda, Ikuo; Shimoyama, Hayato; Chohno, S; Okabayashi, Takehiro; Kagawa, Shunsuke

doi:10.1046/j.1537-2995.1987.27587320526.x

Cited by 104 publications

(43 citation statements)

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“…The more advanced stage of disease, which requires a greater blood loss during the dissection of tumors, the skills of surgeons, and nutri tional status of the patients are suggested as such factors [24], A recent study which prospectively investigated the prognosis of the patients with colorectal cancer who received allogenic or autologous blood transfusions re vealed lower survival rate of the transfused group than the nontransfused patients without differences in survival between the two kinds of transfused group, and concluded that it was not transfusion itself but several factors requir ing transfusions that caused the poor prognosis of trans fused patients [24], 172 Choi et al The relationship between the blood transfusions and survival of patients with curatively resected gastric cancer has not been established. Some studies demonstrated the adverse influence of transfusion on the prognosis of patients with gastric cancer [16,17], On the other hand, a large study by Kampschoer et al [15] showed that blood transfusions did not appear to have deleterious effects on prognosis after stratifying the patients into stages.…”

Section: Discussionmentioning

confidence: 99%

“…The adverse effect of perioperative blood transfusions has been studied in patients with breast cancer [3,4], lung cancer [5,6], soft tissue sarcoma [7], renal cell carcinoma [8], head and neck cancer [9], and most frequently in colo rectal cancer [10][11][12][13][14], Contradictory results have been reported on the effects of perioperative blood transfusions on the prognosis of patients with gastric cancer treated surgically [15][16][17], Therefore, we have undertaken an analysis to investi gate the relationship between perioperative blood transfu-sions and survival of patients with curatively resected locally advanced gastric cancer, which is the most com mon malignancy in Korea [18].…”

Section: Introductionmentioning

confidence: 99%

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Perioperative Blood Transfusions and Prognosis in Patients with Curatively Resected Locally Advanced Gastric Cancer

Choi¹,

Chung

Yoo

et al. 1995

Oncology

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Several reports have demonstrated an adverse effect of perioperative blood transfusions on the survival of patients with various solid tumors treated surgically. We retrospectively investigated the relationship between perioperative blood transfusions and the survival of 501 patients who underwent radical subtotal gastrectomy for locally advanced gastric cancer (stage II-IIIB) from January 1984 to December 1989. Three hundred and fifty-two patients (70.3%) received blood transfusions within the perioperative period. The transfused group included patients with tumors of larger size (5.1 vs. 4.4 cm, p = 0.001) and more advanced stage (stage IIIB: 27.6 vs. 10.7%, p = 0.0001) than the nontransfused group. Although the 5-year overall survival rate was significantly lower (52.9 vs. 66.7%, p = 0.026) in the transfused patients than the nontransfused, subgroup analysis according to the pathologic stage showed no statistically significant difference in survival in each stage between the two groups. In conclusion, we could not find any causal relationships between transfusion and prognosis in patients with curatively resected locally advanced gastric cancer. Circumstances such as advanced stage necessitating transfusions may be more important prognostic factors.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Perioperative Blood Transfusions and Prognosis in Patients with Curatively Resected Locally Advanced Gastric Cancer

Choi¹,

Chung

Yoo

et al. 1995

Oncology

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“…Much less evidence exists with respect to the effect of blood transfusion on the risk of tumor recurrence after resections for colorectal liver metastases [28, 29]. A similar adverse effect of blood transfusion on tumor recurrence has been reported for gastric cancer [23], colon cancer [24, 25], lung cancer [26] and soft tissue carcinoma [27]. The main problem with all these studies remains their retrospective design, which never allows complete ruling out of the possibility that blood transfusion and outcome are affected by a common underlying cause, such as more advanced disease, or more complex surgery.…”

Section: Conclusion and Perspectives For The Futurementioning

confidence: 93%

“…Despite these improvements, blood loss remains one of the main predictors of both perioperative morbidity and mortality after liver resection [7, 10]. The possible negative sequelae of blood transfusions are well known and include alloimmunization [11,12,13,14,15,16], transmission of viral diseases [17], graft-versus-host disease [18], increased postoperative infection rate [16,19,20,21], and increased incidence of tumor recurrence in certain cancers [16,22,23,24,25,26,27]. …”

Section: Introductionmentioning

confidence: 99%

Impact of Blood Loss on Outcome after Liver Resection

Boer¹,

Molenaar²,

Porte³

2007

Dig Surg

137

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Partial liver resections are the treatment of choice for patients with a malignant liver or bile duct tumor. The most frequent indications for partial liver resections are colorectal metastasis, hepatocellular carcinoma (HCC) and cholangiocarcinoma. Liver resection is the only therapy with a chance for cure in these patients. Refinements in surgical technique and increasing experience have contributed to a reduction in perioperative morbidity and mortality in recent years. Despite these improvements, partial liver resections remain a major surgical procedure and carry the risk for excessive blood loss and a subsequent need for blood transfusion. Blood transfusions have been associated with systemic side effects, such as depression of the immune system. Several studies have suggested that perioperative blood loss or transfusions have a negative impact on postoperative outcome. However, it has been debated whether this is due to a real cause-effect relationship or merely the result of more complicated surgery. We have reviewed the literature concerning studies focusing on the relationship between blood loss and blood transfusion during liver surgery for malignant tumors and postoperative outcome. Most studies were based on a retrospective analysis of single center experiences, using uni- and multivariate statistical methods. Most studies have demonstrated a significant and clinically relevant association between blood transfusion and postoperative mortality and morbidity, especially postoperative infectious complications. The effect of blood transfusions on tumor recurrence and more long-term mortality is much less clear and evidence varies depending on the type of malignancy. The strongest indication that blood transfusion may have an impact on tumor recurrence has been found for patients with early stages of HCC. However, overall, no such effect could be demonstrated for patients undergoing partial liver resection for late stages of HCC, colorectal liver metastasis or cholangiocarcinoma.

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“…There have been many reports regarding the effect of perioperative blood transfusions on the prognosis of patients with a variety of digestive organ cancers [1][2][3][4][5]. Although some studies report a deleterious effect of blood transfusions on survival; others report no harmful effects [6][7][8].…”

Section: Introductionmentioning

confidence: 99%

Influence of perioperative blood transfusion on the prognosis of patients with gastric cancer receiving anticancer chemotherapy

et al. 2000

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BACKGROUND: The deleterious effect of blood transfusions on survival has been reported in patients with cancers of various organs. However, it remains unclear whether there is any adverse effect of blood transfusion when the patients are administered anticancer drugs after surgery for gastric cancers.METHODS: Data from patients with gastric resection for advanced gastric cancer were retrospectively analyzed to determine the influence of perioperative blood transfusion on the survival rate. All patients were administered anticancer drugs (mitomycin C [MMC] and tegafur-uracil [UFT]). Sixty-nine (33%) of 208 patients received blood transfusion perioperatively, while 139 patients (67%) did not receive transfusion. Multivariate analysis of clinicopathologic prognostic factors, including blood transfusion, was performed. Lymphocyte subsets were measured to investigate the immunosuppressive effect of blood transfusion.RESULTS: The 5-year survival rate was 48.8% in the 69 transfused patients and 66.9% in the 139 non-transfused patients ( P < 0.01). Cox's multiple regression analysis showed that, when patients received anticancer drugs, perioperative blood transfusion was not a significant factor affecting survival after the gastric cancer surgery. However, the CD4/CD8 ratio at 3 months after the surgery was significantly lower in the transfused group than in the non-transfused group.CONCLUSION: Blood transfusion did not affect the survival of operated patients who received postoperative adjuvant chemotherapy. However, the finding that the ratio of CD4/CD8 after surgery was significantly higher in the non-transfused group than in the transfused group supports the notion that transfusion causes broad-spectrum immunosuppression.

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Adverse affect of blood transfusions on survival of patients with gastric cancer

Cited by 104 publications

References 10 publications

Perioperative Blood Transfusions and Prognosis in Patients with Curatively Resected Locally Advanced Gastric Cancer

Perioperative Blood Transfusions and Prognosis in Patients with Curatively Resected Locally Advanced Gastric Cancer

Impact of Blood Loss on Outcome after Liver Resection

Influence of perioperative blood transfusion on the prognosis of patients with gastric cancer receiving anticancer chemotherapy

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