23 May 2017 : Clinical Research
Correlations of Hemoglobin Level and Perioperative Blood Transfusion with the Prognosis of Gastric Cancer: A Retrospective StudyGang Wu1ABE, Dai-Yang Zhang2BCE, Yu-Han Duan3CF, Ying-Qiong Zhang4EF, Xian-Nian Cui5CD, Zheng Luo2ABCE*
Med Sci Monit 2017; 23:2470-2478
BACKGROUND: This study was designed to explore the correlations of hemoglobin level (Hb) and perioperative blood transfusion with the prognosis of gastric cancer (GC).
MATERIAL AND METHODS: Our study consisted of 210 patients with GC who all received a D2 radical operation. These patients were assigned into three groups: 68 cases in group A (blood transfusion >5 U); 59 cases in group B (blood transfusion <5 U); 83 cases in group C (without blood transfusion). A 5-year follow-up was conducted to evaluate the disease-free survival of the patients. Univariate analysis was performed to reveal the relationship between the indicators and the patients with GC. Kaplan-Meier method was employed to analyze the survival rate of patients, and Cox regression analysis was applied to determine the independent prognostic factors of GC.
RESULTS: The univariate analysis indicated that age, perioperative blood transfusion amount, TNM staging, maximal tumor diameter, differentiation degree and invasion degree were associated with the prognosis of GC. The Kaplan-Meier curve showed that the disease-free survival rate was declined in the patients who were older, those received more amount of blood transfusion, those in advanced TNM staging, those had larger tumor diameter, and those with decreased degree of differentiation and invasion. Cox regression analysis indicated that perioperative blood transfusion, maximal tumor diameter and invasion degree were the independent factors affecting disease-free survival of the GC.
CONCLUSIONS: Our study revealed that large amount of perioperative blood transfusion leads to poor prognosis of GC.
Keywords: Blood Transfusion, Disease-Free Survival, Hemoglobin A, perioperative period, Prognosis
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