DOES PERIOPERATIVE BLOOD-TRANSFUSION INFLUENCE LONG-TERM PROGNOSIS OFGASTRIC-CANCER

We analyzed the influence of packed red blood cell (PRBC) transfusions on the prognosis of 163 patients with gastric adenocarcinoma undergoi ng subtotal gastrectomy with a curative intention. Over a period of 15 years, our department admitted 505 patients with gastric adenocarcino ma, with curative subtotal gastrectomy being performed in 167 cases. M ean age was 62.2 years (range: 30-87); there was a predominance of mal es (104 cases; 63.8%). Excluding the four patients who died in the imm ediate postoperative period (first 30 days), the remaining 163 were re viewed twice yearly in our department until either they died or the st udy ended. Follow-up averaged 49.5 months, with a median of 36 months. Sixty-nine (42.3%) of the 163 patients received transfusions of PRBC. On correlating the variables with the transfusion, we found a statist ical significance only between the rate of transfusion and patient age over 63 years (P < 0.01), with an evolution time of less than three m onths (P < 0.05) and in tumors of >4 cm (P < 0.05). The five-year surv ival rate of the nontransfusion patients was 56.9% and of the transfus ion patients 40%, with statistically significant differences (P = 0.01 32). On studying patients according to tumor stage, we found that bloo d transfusion had a statistically significant influence on prognosis o nly in patients with tumor stage III (P = 0.0051). In the univariate a nalysis of the remaining variables collected, the existence of abdomin al tumor (P = 0.0307), tumor size (P = 0.00001), degree of involvement of the gastric wall (P = 0.00001), lymph node involvement (P = 0.0000 1) and tumor stage (P = 0.00001) revealed a statistically significant influence on prognosis. If we apply Cox's regression model to the vari ables that in the univariate analysis had a statistically significant influence on prognosis, we found that only tumor size and stage were i ndependent predictors of survival. In our experience, PRBC transfusion does not influence the long-term survival of patients with resected g astric adenocarcinoma.