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No detrimental effect of perioperative blood transfusion on recurrence in 2905 stage II/III gastric cancer patients: A propensity-score matching analysis

  • Jeong Ho Song
    Affiliations
    Department of Surgery, Yonsei University College of Medicine, Seoul, South Korea

    Department of Surgery, Ajou University School of Medicine, Suwon, South Korea
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  • Hye Jung Shin
    Affiliations
    Department of Biomedical Systems Informatics, Biostatistics Collaboration Unit, Yonsei University College of Medicine, Seoul, South Korea
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  • Sejin Lee
    Affiliations
    Department of Surgery, Yonsei University College of Medicine, Seoul, South Korea

    Gastric Cancer Center, Yonsei Cancer Center, Yonsei University Health System, Seoul, South Korea
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  • Sung Hyun Park
    Affiliations
    Department of Surgery, Yonsei University College of Medicine, Seoul, South Korea

    Gastric Cancer Center, Yonsei Cancer Center, Yonsei University Health System, Seoul, South Korea
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  • Minah Cho
    Affiliations
    Department of Surgery, Yonsei University College of Medicine, Seoul, South Korea

    Gastric Cancer Center, Yonsei Cancer Center, Yonsei University Health System, Seoul, South Korea
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  • Yoo Min Kim
    Affiliations
    Department of Surgery, Yonsei University College of Medicine, Seoul, South Korea

    Gastric Cancer Center, Yonsei Cancer Center, Yonsei University Health System, Seoul, South Korea
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  • Woo Jin Hyung
    Affiliations
    Department of Surgery, Yonsei University College of Medicine, Seoul, South Korea

    Gastric Cancer Center, Yonsei Cancer Center, Yonsei University Health System, Seoul, South Korea
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  • Hyoung-Il Kim
    Correspondence
    Corresponding author. Department of Surgery, Yonsei University College of Medicine, 50-1 Yonsei-ro Seodaemun-gu, Seoul, 03722, Republic of Korea
    Affiliations
    Department of Surgery, Yonsei University College of Medicine, Seoul, South Korea

    Gastric Cancer Center, Yonsei Cancer Center, Yonsei University Health System, Seoul, South Korea
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      Abstract

      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.

      Keywords

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