Relationship between Perioperative Blood Transfusion and Prognosis after Surgery for Early Gastric Cancer with Regard to Causes of Death

Tsuneaki Fujiya, Hideaki Yamanami, Junichi Mikuni, Yoichiro Kakugawa, Yasuhiko Kamiyama, Hidemaro Ono, Tohoru Sugawara and Kiyoaki Ouchi

Department of Surgery, Miyagi Cancer Center

To evaluate the relationship between perioperative blood transfusion (PBT) and survival time over 10 years after curative gastrectomy for early gastric cancer (EGC), we reviewed 776 patients retrospectively treated surgically in Miyagi cancer center from 1967 to 1986. Of these 776, 140 (18.1%) patients received PBT. The percentage of elderly (70 years or older), submucosal invasion, lower hemoglobin content (<14 g/dl), total gastrectomy, chemotherapy and earlier operative periods (1967∼1976) in transfused patients were significantly higher than those in non-transfused patients. A total of 653 patients (84.1%) survived over 10 years after surgery, 91 patients (11.7%) died of some causes unrelated to gastric cancer (unrelated causes), and 29 patients (3.7%) died of causes related to gastric cancer (related causes). In comparison with transfused patients to non-transfused patients there is not significant difference in cause of death. Using only unrelated causes in Cox multivariate analysis, the independent prognostic factors were elderly, male, earlier operative period, total gastrectomy and PBT. In our current study, PBT inversely affects long-term survival of the patients with EGC by increasing the number of death by some causes unrelated to gastric cancer. In conclusion, it is important to avoid an unnecessary PBT for long-term survival of the patients with EGC.

Key words
early gastric cancer, prognostic factor, multivariate analysis, causes of death, perioperative blood transfusion

Reprint requests
Tsuneaki Fujiya Department of Surgery, Miyagi Cancer Center, 47-1 Nodayama, Medeshima-Shiode, Natori, 981-1293 JAPAN

Accepted
September 22, 1999

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