Effect of Perioperative Blood Transfusions and Infectious Complications on Inflammatory Activation and Long-Term Survival Following Gastric Cancer Resection
Background: The aim of this study was to evaluate the impact of perioperative blood transfusion and infectious complications on postoperative changes of inflammatory markers, as well as on disease-free survival (DFS) in patients undergoing curative gastric cancer resection. Methods: Multicenter coho...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-12-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/15/1/144 |
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| author | Noelia Puértolas Javier Osorio Carlos Jericó Coro Miranda Maite Santamaría Eva Artigau Gonzalo Galofré Elisenda Garsot Alexis Luna Aurora Aldeano Carles Olona Joan Molinas Laura Pulido Marta Gimeno Manuel Pera |
| author_facet | Noelia Puértolas Javier Osorio Carlos Jericó Coro Miranda Maite Santamaría Eva Artigau Gonzalo Galofré Elisenda Garsot Alexis Luna Aurora Aldeano Carles Olona Joan Molinas Laura Pulido Marta Gimeno Manuel Pera |
| author_sort | Noelia Puértolas |
| collection | DOAJ |
| description | Background: The aim of this study was to evaluate the impact of perioperative blood transfusion and infectious complications on postoperative changes of inflammatory markers, as well as on disease-free survival (DFS) in patients undergoing curative gastric cancer resection. Methods: Multicenter cohort study in all patients undergoing gastric cancer resection with curative intent. Patients were classified into four groups based on their perioperative course: one, no blood transfusion and no infectious complication; two, blood transfusion; three, infectious complication; four, both transfusion and infectious complication. Neutrophil-to-lymphocyte ratio (NLR) was determined at diagnosis, immediately before surgery, and 10 days after surgery. A multivariate Cox regression model was used to analyze the relationship of perioperative group and dynamic changes of NLR with disease-free survival. Results: 282 patients were included, 181 in group one, 23 in group two, 55 in group three, and 23 in group four. Postoperative NLR changes showed progressive increase in the four groups. Univariate analysis showed that NLR change > 2.6 had a significant association with DFS (HR 1.55; 95% CI 1.06–2.26; <i>p</i> = 0.025), which was maintained in multivariate analysis (HR 1.67; 95% CI 1.14–2.46; <i>p</i> = 0.009). Perioperative classification was an independent predictor of DFS, with a progressive difference from group one: group two, HR 0.80 (95% CI: 0.40–1.61; <i>p</i> = 0.540); group three, HR 1.42 (95% CI: 0.88–2.30; <i>p</i> = 0.148), group four, HR 2.85 (95% CI: 1.64–4.95; <i>p</i> = 0.046). Conclusions: Combination of perioperative blood transfusion and infectious complications following gastric cancer surgery was related to greater NLR increase and poorer DFS. These findings suggest that perioperative blood transfusion and infectious complications may have a synergic effect creating a pro-inflammatory activation that favors tumor recurrence. |
| first_indexed | 2024-03-11T10:07:00Z |
| format | Article |
| id | doaj.art-97df9f07b8b043cdb0ca2bea6bdd4fe9 |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-11T10:07:00Z |
| publishDate | 2022-12-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-97df9f07b8b043cdb0ca2bea6bdd4fe92023-11-16T15:02:14ZengMDPI AGCancers2072-66942022-12-0115114410.3390/cancers15010144Effect of Perioperative Blood Transfusions and Infectious Complications on Inflammatory Activation and Long-Term Survival Following Gastric Cancer ResectionNoelia Puértolas0Javier Osorio1Carlos Jericó2Coro Miranda3Maite Santamaría4Eva Artigau5Gonzalo Galofré6Elisenda Garsot7Alexis Luna8Aurora Aldeano9Carles Olona10Joan Molinas11Laura Pulido12Marta Gimeno13Manuel Pera14Service of Surgery, Hospital Universitari Mútua Terrassa, 08221 Terrassa, SpainDepartment of Surgery, Hospital Universitari de Bellvitge, L’Hospitalet del Llobregat, 08037 Barcelona, SpainService of Internal Medicine, Hospital de Sant Joan Despí Moisès Broggi, 08970 Sant Joan Despí, SpainService of Surgery, Hospital Universitario de Navarra, 31008 Pamplona, SpainService of Surgery, Hospital Universitari Arnau de Vilanova, 25198 Lleida, SpainService of Surgery, Hospital Universitari Josep Trueta, 17007 Girona, SpainService of Surgery, Hospital de Sant Joan Despí Moisès Broggi, 08970 Sant Joan Despí, SpainService of Surgery, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, 08916 Badalona, SpainService of Surgery, Consorci Corporació Sanitària Parc Taulí de Sabadell, 08208 Sabadell, SpainService of Surgery, Hospital General de Granollers, 08402 Granollers, SpainService of Surgery, Hospital Universitari de Tarragona, Joan XXIII, 43005 Tarragona, SpainService of Surgery, Hospital Universitari de Vic, 08500 Vic, SpainService of Surgery, Hospital de Mataró, Consorci Sanitari del Maresme, 08304 Mataró, SpainSection of Gastrointestinal Surgery, Hospital Universitario del Mar, Universitat Autònoma de Barcelona, Hospital del Mar Medical Research Institute (IMIM), 08003 Barcelona, SpainSection of Gastrointestinal Surgery, Hospital Universitario del Mar, Universitat Autònoma de Barcelona, Hospital del Mar Medical Research Institute (IMIM), 08003 Barcelona, SpainBackground: The aim of this study was to evaluate the impact of perioperative blood transfusion and infectious complications on postoperative changes of inflammatory markers, as well as on disease-free survival (DFS) in patients undergoing curative gastric cancer resection. Methods: Multicenter cohort study in all patients undergoing gastric cancer resection with curative intent. Patients were classified into four groups based on their perioperative course: one, no blood transfusion and no infectious complication; two, blood transfusion; three, infectious complication; four, both transfusion and infectious complication. Neutrophil-to-lymphocyte ratio (NLR) was determined at diagnosis, immediately before surgery, and 10 days after surgery. A multivariate Cox regression model was used to analyze the relationship of perioperative group and dynamic changes of NLR with disease-free survival. Results: 282 patients were included, 181 in group one, 23 in group two, 55 in group three, and 23 in group four. Postoperative NLR changes showed progressive increase in the four groups. Univariate analysis showed that NLR change > 2.6 had a significant association with DFS (HR 1.55; 95% CI 1.06–2.26; <i>p</i> = 0.025), which was maintained in multivariate analysis (HR 1.67; 95% CI 1.14–2.46; <i>p</i> = 0.009). Perioperative classification was an independent predictor of DFS, with a progressive difference from group one: group two, HR 0.80 (95% CI: 0.40–1.61; <i>p</i> = 0.540); group three, HR 1.42 (95% CI: 0.88–2.30; <i>p</i> = 0.148), group four, HR 2.85 (95% CI: 1.64–4.95; <i>p</i> = 0.046). Conclusions: Combination of perioperative blood transfusion and infectious complications following gastric cancer surgery was related to greater NLR increase and poorer DFS. These findings suggest that perioperative blood transfusion and infectious complications may have a synergic effect creating a pro-inflammatory activation that favors tumor recurrence.https://www.mdpi.com/2072-6694/15/1/144perioperative transfusioninfectious complicationsinflammatory markersgastric cancergastrectomypatient blood management |
| spellingShingle | Noelia Puértolas Javier Osorio Carlos Jericó Coro Miranda Maite Santamaría Eva Artigau Gonzalo Galofré Elisenda Garsot Alexis Luna Aurora Aldeano Carles Olona Joan Molinas Laura Pulido Marta Gimeno Manuel Pera Effect of Perioperative Blood Transfusions and Infectious Complications on Inflammatory Activation and Long-Term Survival Following Gastric Cancer Resection Cancers perioperative transfusion infectious complications inflammatory markers gastric cancer gastrectomy patient blood management |
| title | Effect of Perioperative Blood Transfusions and Infectious Complications on Inflammatory Activation and Long-Term Survival Following Gastric Cancer Resection |
| title_full | Effect of Perioperative Blood Transfusions and Infectious Complications on Inflammatory Activation and Long-Term Survival Following Gastric Cancer Resection |
| title_fullStr | Effect of Perioperative Blood Transfusions and Infectious Complications on Inflammatory Activation and Long-Term Survival Following Gastric Cancer Resection |
| title_full_unstemmed | Effect of Perioperative Blood Transfusions and Infectious Complications on Inflammatory Activation and Long-Term Survival Following Gastric Cancer Resection |
| title_short | Effect of Perioperative Blood Transfusions and Infectious Complications on Inflammatory Activation and Long-Term Survival Following Gastric Cancer Resection |
| title_sort | effect of perioperative blood transfusions and infectious complications on inflammatory activation and long term survival following gastric cancer resection |
| topic | perioperative transfusion infectious complications inflammatory markers gastric cancer gastrectomy patient blood management |
| url | https://www.mdpi.com/2072-6694/15/1/144 |
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