PERIOPERATIVE BLOOD-TRANSFUSIONS AND PROGNOSIS IN PATIENTS WITH CURATIVELY RESECTED LOCALLY ADVANCED GASTRIC-CANCER

Several reports have demonstrated an adverse effect of perioperative b lood transfusions on the survival of patients with various solid tumor s treated surgically. We retrospectively investigated the relationship between perioperative blood transfusions and the survival of 501 pati ents who underwent radical subtotal gastrectomy for locally advanced g astric cancer (stage II-IIIB) from January 1984 to December 1989. Thre e hundred and fifty-two patients (70.3%) received blood transfusions w ithin the perioperative period. The transfused group included patients with tumors of larger size (5.1 vs. 4.4 cm, p = 0.001) and more advan ced stage (stage IIIB: 27.6 vs. 10.7%, p = 0.0001) than the nontransfu sed 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 sh owed no statistically significant difference in survival in each stage between the two groups. In conclusion, we could not find any causal r elationships between transfusion and prognosis in patients with curati vely resected locally advanced gastric cancer. Circumstances such as a dvanced stage necessitating transfusions may be more important prognos tic factors.