Do Perioperative Blood Transfusions Influence Prognosis of Gastric Cancer Patients? Analysis of 927 Patients and Interactions with Splenectomy

Abstract

Our study indicates a slightly, but not significantly, negative effect of allogeneic blood transfusion on prognosis of gastric cancer patients. In the subgroup of patients who underwent total gastrectomy, splenectomy seems to invert this mild effect, with a positive influence on overall survival.

Adverse Effects of Intraoperative Blood Loss on Long-Term Outcomes after Curative Gastrectomy of Patients with Stage II/III Gastric Cancer

“…First, evidence indicates that excessive EBL may by itself impair immunity against cancer cells and nutritional status via loss of plasma constituents [8,27] . Further, patients' immunonutritional status plays an important role in tumor immunity [28] .…”

Allogeneic blood transfusion and the prognosis of gastric cancer patients: Systematic review and meta-analysis

“…For the 2 studies, the indications for blood transfusions were different. One [23] was a multicenter study in Italy in which the indication for transfusion was a hemoglobin level of 8e10 g/dL or hemodynamically significant intraoperative blood loss. The indication in the other study [15] was intraoperative blood loss of >1000 mL or a hemoglobin level of <8 g/dL undertaken in a single center in Japan.…”

“…A meta-regression analysis undertaken to explore explanations for tau 2 suggested that geographic area and tumor stage were not the significant sources of heterogeneity (Table 3). Using Galbraith plot, 2 studies [15,23] were found to be sources of heterogeneity (Fig. 4).…”

Effect of Perioperative Transfusion on Recurrence and Survival after Gastric Cancer Resection: A 7-Institution Analysis of 765 Patients from the US Gastric Cancer Collaborative

“…[12][13][14] Additionally, the interaction of splenectomy with transfusion in patients undergoing GAC resection has been debated. 9,10,12 The adverse effects of perioperative transfusion on patients undergoing curative resection of GAC and other malignancies have been hypothesized to be immune-mediated and perhaps dependent upon an intact spleen.…”