The Associations between Perioperative Blood Transfusion and Long-Term Outcomes after Stomach Cancer Surgery
Background: Whether perioperative packed red blood cell (pRBC) transfusion is associated with inferior long-term outcomes after stomach cancer surgery remains controversial. Methods: This research used a retrospective cohort study. Patients with stage I~III stomach cancer undergoing tumor resection...
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MDPI AG
2021-10-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/13/21/5438 |
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| author | Fu-Kai Hsu Wen-Kuei Chang Kuan-Ju Lin Chun-Yu Liu Wen-Liang Fang Kuang-Yi Chang |
| author_facet | Fu-Kai Hsu Wen-Kuei Chang Kuan-Ju Lin Chun-Yu Liu Wen-Liang Fang Kuang-Yi Chang |
| author_sort | Fu-Kai Hsu |
| collection | DOAJ |
| description | Background: Whether perioperative packed red blood cell (pRBC) transfusion is associated with inferior long-term outcomes after stomach cancer surgery remains controversial. Methods: This research used a retrospective cohort study. Patients with stage I~III stomach cancer undergoing tumor resection were collected at a tertiary medical center. Patient characteristics, surgical features and pathologic findings were gathered from an electronic medical chart review. The associations of perioperative pRBC transfusion with postoperative disease-free and overall survivals were evaluated using Cox regression analysis with an inverse probability of treatment weighting (IPTW). Restricted cubic spline functions were employed to characterize dose-response relationships between the amount of transfusion and cancer outcomes after surgery. Results: Among the 569 patients, 160 (28.1%) received perioperative pRBC transfusion. Perioperative transfusion was associated with worse disease-free survival (IPTW adjusted HR: 1.42, 95% CI: 1.18–1.71, <i>p</i> < 0.001) and overall survival (IPTW adjusted HR: 1.27, 95% CI: 1.05–1.55, <i>p</i> = 0.014). A non-linear dose-response relationship was noted between the amount of transfusions and worse disease-free or overall survival. Conclusions: Perioperative pRBC transfusion was associated with worse disease-free and overall survival after stomach cancer surgery, and strategies aiming to minimize perioperative transfusion exposure should be further considered to reduce the potential risk. |
| first_indexed | 2024-03-10T06:05:42Z |
| format | Article |
| id | doaj.art-8f67ef1f7b024fad8d57262a7acdccff |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-10T06:05:42Z |
| publishDate | 2021-10-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-8f67ef1f7b024fad8d57262a7acdccff2023-11-22T20:35:13ZengMDPI AGCancers2072-66942021-10-011321543810.3390/cancers13215438The Associations between Perioperative Blood Transfusion and Long-Term Outcomes after Stomach Cancer SurgeryFu-Kai Hsu0Wen-Kuei Chang1Kuan-Ju Lin2Chun-Yu Liu3Wen-Liang Fang4Kuang-Yi Chang5Department of Anesthesiology, Taipei Veterans General Hospital, No. 201, Sec. 2, Shih-Pai Rd, Taipei 112201, TaiwanDepartment of Anesthesiology, Taipei Veterans General Hospital, No. 201, Sec. 2, Shih-Pai Rd, Taipei 112201, TaiwanDepartment of Anesthesiology, Taipei Veterans General Hospital, No. 201, Sec. 2, Shih-Pai Rd, Taipei 112201, TaiwanSchool of Medicine, National Yang Ming Chiao Tung University, Taipei 112304, TaiwanSchool of Medicine, National Yang Ming Chiao Tung University, Taipei 112304, TaiwanDepartment of Anesthesiology, Taipei Veterans General Hospital, No. 201, Sec. 2, Shih-Pai Rd, Taipei 112201, TaiwanBackground: Whether perioperative packed red blood cell (pRBC) transfusion is associated with inferior long-term outcomes after stomach cancer surgery remains controversial. Methods: This research used a retrospective cohort study. Patients with stage I~III stomach cancer undergoing tumor resection were collected at a tertiary medical center. Patient characteristics, surgical features and pathologic findings were gathered from an electronic medical chart review. The associations of perioperative pRBC transfusion with postoperative disease-free and overall survivals were evaluated using Cox regression analysis with an inverse probability of treatment weighting (IPTW). Restricted cubic spline functions were employed to characterize dose-response relationships between the amount of transfusion and cancer outcomes after surgery. Results: Among the 569 patients, 160 (28.1%) received perioperative pRBC transfusion. Perioperative transfusion was associated with worse disease-free survival (IPTW adjusted HR: 1.42, 95% CI: 1.18–1.71, <i>p</i> < 0.001) and overall survival (IPTW adjusted HR: 1.27, 95% CI: 1.05–1.55, <i>p</i> = 0.014). A non-linear dose-response relationship was noted between the amount of transfusions and worse disease-free or overall survival. Conclusions: Perioperative pRBC transfusion was associated with worse disease-free and overall survival after stomach cancer surgery, and strategies aiming to minimize perioperative transfusion exposure should be further considered to reduce the potential risk.https://www.mdpi.com/2072-6694/13/21/5438blood transfusiondisease-free survivaldose-responsesurvival analysisstomach neoplasms |
| spellingShingle | Fu-Kai Hsu Wen-Kuei Chang Kuan-Ju Lin Chun-Yu Liu Wen-Liang Fang Kuang-Yi Chang The Associations between Perioperative Blood Transfusion and Long-Term Outcomes after Stomach Cancer Surgery Cancers blood transfusion disease-free survival dose-response survival analysis stomach neoplasms |
| title | The Associations between Perioperative Blood Transfusion and Long-Term Outcomes after Stomach Cancer Surgery |
| title_full | The Associations between Perioperative Blood Transfusion and Long-Term Outcomes after Stomach Cancer Surgery |
| title_fullStr | The Associations between Perioperative Blood Transfusion and Long-Term Outcomes after Stomach Cancer Surgery |
| title_full_unstemmed | The Associations between Perioperative Blood Transfusion and Long-Term Outcomes after Stomach Cancer Surgery |
| title_short | The Associations between Perioperative Blood Transfusion and Long-Term Outcomes after Stomach Cancer Surgery |
| title_sort | associations between perioperative blood transfusion and long term outcomes after stomach cancer surgery |
| topic | blood transfusion disease-free survival dose-response survival analysis stomach neoplasms |
| url | https://www.mdpi.com/2072-6694/13/21/5438 |
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