- Volume 17 Issue 3
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Impact of Peri-Operative Anemia and Blood Transfusions in Patients with Gastric Cancer Receiving Gastrectomy
- Chang, Chih-Chun ;
- Sun, Jen-Tang ;
- Chen, Jing-Yuan ;
- Chen, Yi-Ting ;
- Li, Pei-Yu ;
- Lee, Tai-Chen ;
- Su, Ming-Jang ;
- Wu, Jiann-Ming ;
- Yen, Tzung-Hai ;
- Chu, Fang-Yeh
- Published : 2016.04.11
Background: Potential disadvantages of blood transfusion during curative gastrectomy for gastric cancer have been reported, and the role of peri-operative transfusions remains to be ascertained. Thus, the aim of our study was to survey its impact in patients with gastric cancer undergoinging gastrectomy. Materials and Methods: Clinical data of patients receiving curative gastrectomy at Far Eastern Memorial Hospital were obtained. Findings for pre-operative anemia states, pre-, peri- and post-operative transfusion of red blood cell (RBC) products as well as post-operative complication events were collected for univariate analysis. Results: A total of 116 patients with gastric cancer received gastrectomy at Far Eastern Memorial Hospital from 2011 to 2014. Both pre-operative and intra- and post-operative transfusion of RBC products were markedly associated with post-operative infectious events (OR: 3.70, 95% CI: 1.43-9.58, P=0.002; OR: 8.20, 95% CI: 3.11-22.62, P<0.001, respectively). In addition, peri- and post-operative RBC transfusion was significantly associated with prolonged hospital stay from admission to discharge (OR: 8.66, 95% CI: 1.73-83.00, P=0.002) and post-operative acute renal failure (OR: 19.69, 95% CI: 2.66-854.56, P<0.001). Also, the overall survival was seemingly decreased by peri-operative RBC transfusion in our gastric cancer cases (P=0.078). Conclusions: Our survey indicated that peri-operative RBC transfusion could increase the risk of infectious events and acute renal failure post curative gastrectomy as well as worsen the overall survival in gastric cancer cases. Hence, unnecessary blood transfusion before, during and after curative gastrectomy should be avoided in patients with gastric cancer.
Peri-operative transfusion;gastric cancer;gastrectomy;red blood cells
- Aquina CT, Blumberg N, Probst CP, et al (2015). Significant Variation in Blood Transfusion Practice Persists following Upper GI Cancer Resection. J Gastrointest Surg, 19, 1927-37. https://doi.org/10.1007/s11605-015-2903-3
- Borstlap WA, Buskens CJ, Tytgat KM, et al (2015). Multicentre randomized controlled trial comparing ferric(III) carboxymaltose infusion with oral iron supplementation in the treatment of preoperative anaemia in colorectal cancer patients. BMC Surg, 15, 78. https://doi.org/10.1186/s12893-015-0065-6
- Devon KM, McLeod RS (2009). Pre and peri-operative erythropoietin for reducing allogeneic blood transfusions in colorectal cancer surgery. Cochrane Database Syst Rev, 1, 7148.
- Diaz-Cambronero O, Matoses-Jaen S, Garcia-Claudio N, et al (2015). Preoperative management of anemia in oncologic surgery. Rev Esp Anestesiol Reanim, 62, 45-51. https://doi.org/10.1016/S0034-9356(15)30007-4
- Gantt CL (1981). Red blood cells for cancer patients. Lancet, 12, 363.
- Gierth M, Mayr R, Aziz A, et al (2015). Preoperative anemia is associated with adverse outcome in patients with urothelial carcinoma of the bladder following radical cystectomy. J Cancer Res Clin Oncol, 141, 1819-26. https://doi.org/10.1007/s00432-015-1957-7
- Inoue S, Miyoshi T, Aoyama M, et al (2015). A case of thoracic esophageal cancer undergone esophagectomy after induction chemotherapy in a Jehovah's Witness. J Med Invest, 62, 264-7. https://doi.org/10.2152/jmi.62.264
- Kang RY, Lee J, Lee YH, et al (2012). Impact of erythropoiesis-stimulating agents on red blood cell transfusion in Korea. Int J Clin Pharm, 34, 651-7. https://doi.org/10.1007/s11096-012-9660-0
- Lee BW, Park MG, Cho DY, et al (2014). Preoperative erythropoietin administration in patients with prostate cancer undergoing radical prostatectomy without transfusion. Korean J Urol, 55, 102-5. https://doi.org/10.4111/kju.2014.55.2.102
- Li XX, Meng J, Sun GP, et al (2015). Effects of perioperative blood transfusion on the prognosis in hereditary and sporadic colon cancer. Biomarkers, 20, 481-6. https://doi.org/10.3109/1354750X.2015.1096306
- Maccio A, Madeddu C, Gramignano G, et al (2015). The role of inflammation, iron, and nutritional status in cancer-related anemia: results of a large, prospective, observational study. Haematologica, 100, 124-32. https://doi.org/10.3324/haematol.2014.112813
- Meng J, Lu XB, Tang YX, et al (2013). Effects of allogeneic blood transfusion in patients with stage II colon cancer. Asian Pac J Cancer Prev, 14, 347-50. https://doi.org/10.7314/APJCP.2013.14.1.347
- Oh SY, Kim SH, Kwon HC, et al (2010). Bloodless cancer treatment results of patients who do not want blood transfusion: single center experience of 77 cases. Support Care Cancer, 18, 1341-6. https://doi.org/10.1007/s00520-009-0759-3
- Ojima T, Iwahashi M, Nakamori M, et al (2009). Association of allogeneic blood transfusions and long-term survival of patients with gastric cancer after curative gastrectomy. J Gastrointest Surg, 13, 1821-30. https://doi.org/10.1007/s11605-009-0973-9
- Prescott LS, Aloia TA, Brown AJ, et al (2015). Perioperative blood transfusion in gynecologic oncology surgery: analysis of the national surgical quality improvement program database. Gynecol Oncol, 136, 65-70. https://doi.org/10.1016/j.ygyno.2014.11.009
- Rausei S, Ruspi L, Galli F, et al (2013). Peri-operative blood transfusion in gastric cancer surgery: prognostic or confounding factor? Int J Surg, 11, S100-3. https://doi.org/10.1016/S1743-9191(13)60027-8
- Squires MH 3rd, Kooby DA, Poultsides GA, et al (2015). 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. J Am Coll Surg, 221, 767-77. https://doi.org/10.1016/j.jamcollsurg.2015.06.012
- Sun C, Wang Y, Yao HS, et al (2015). Allogeneic blood transfusion and the prognosis of gastric cancer patients: systematic review and meta-analysis. Int J Surg, 13, 102-10. https://doi.org/10.1016/j.ijsu.2014.11.044
- Tsai HW, Hsieh FC, Chang CC, et al (2015). Clinical practice of blood transfusion in orthotopic organ transplantation: a single institution experience. Asian Pac J Cancer Prev, 16, 8009-13. https://doi.org/10.7314/APJCP.2015.16.17.8009
- Xiao H, Zuo C, Ouyang Y, et al (2014). Multivariate analysis of risk factors for pulmonary infection after radical gastrectomy for gastric cancer. Zhonghua Yi Xue Za Zhi, 94, 3310-3.
- Yang K, Chen XZ, Zhang WH, et al (2015). Effect of Perioperative Transfusion on Survival and Morbidity for Gastric Cancer Patients with Gastrectomy. J Am Coll Surg, 221, 995-6. https://doi.org/10.1016/j.jamcollsurg.2015.07.449
- Ye X, Liu J, Chen Y, et al (2015). The impact of hemoglobin level and transfusion on the outcomes of chemotherapy in gastric cancer patients. Int J Clin Exp Med, 8, 4228-35.
- Yu JC, Ge JN, Tang Y, et al (2011). Multicenter cross-sectional study of anemia in patients with gastric and colorectal cancer before and after the operation. Zhonghua Wai Ke Za Zhi, 49, 53-6.
- Zhou HY, Yi W, Wang J, et al (2014). Association of perioperative allogeneic blood transfusions and prognosis of patients with gastric cancer after curative gastrectomy. Am J Surg, 208, 80-7. https://doi.org/10.1016/j.amjsurg.2013.08.029
- genotype and perioperative blood transfusion are not conducive to the prognosis of patients with gastric cancer vol.32, pp.7, 2018, https://doi.org/10.1002/jcla.22443
- Preoperative Anemia or Low Hemoglobin Predicts Poor Prognosis in Gastric Cancer Patients: A Meta-Analysis vol.2019, pp.1875-8630, 2019, https://doi.org/10.1155/2019/7606128
Supported by : Far Eastern Memorial Hospital