Background: The effects of perioperative blood transfusion on the prognosis of gastric cancer patients remain controversial. This study aimed to assess the association between perioperative blood transfusion and survival outcomes. Methods: The study included 2905 patients who underwent curative gastrectomy for stage II/III gastric cancer between 2006 and 2015 and were followed until 2018. Propensity-score matching was used to adjust for differences in baseline clinicopathologic characteristics between patients with or without blood transfusion. Results: Of 2905 patients, 543 (18.7%) received a perioperative blood transfusion. Patients with blood transfusion had significantly worse overall survival and recurrence-free survival than those without blood transfusion (p < 0.001 for both). Survival outcomes did not differ according to timing of transfusion (preoperative, intraoperative, or postoperative), transfused volume (1–2 units of packed red cells vs ≥ 3 units of packed red blood cells), and volume of intraoperative blood loss (≤300 mL vs > 300 mL). After propensity-score matching adjusting for risk factors associated with blood transfusion, 498 patients were included in each group. Long-term recurrence-free survival was not significantly different between patients with or without blood transfusion in the matched analysis (p = 0.808). Conclusions: In propensity-score matched analysis, blood transfusion was not associated with recurrence-free survival. Clinical circumstances, including demographic, pathologic, and surgical characteristics, rather than blood transfusions, appear to be the main prognostic factors for recurrence.
Bibliographical noteFunding Information:
This work was supported by a National Research Foundation of Korea grant funded by the Korea government (MSIT; No. 2019R1H1A2079953 ).
© 2022 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology
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