The effect of perioperative blood transfusion on the survival rate of patients with gastric canceer was studied. Three hundred sixty eight patients with primary gastric cancer, who received curative surgery in Hanyang university hospital from
1988
to
1993, were studied retrospectively. The median follow-up for these patients were 23.0 months, wheras the median survival for nonsurvivors was 14.0 months. By chi-square analysis, male sex(p=0.00079), advanced T-stage(p=0.00003), Borrmann's type
III
&
IV(p=0.00117), advanced stage of disease(p=0.00042), nodal metastasis(p=0.00395), extensive lymph nodes dissecion(p=0.03821) and chemotherapy(p=0.00273) were associated with greater likelihood of transfusion. By univariate analysis, old
age(p=0.0075),
advanced T-stage(p<0.00001), Borrmann's type III& IV(p<0.00001), nodal metastasis(p<0.00001), advanced stage of disease(p<0.00001) and transfusion(p=0.0001) were predictors of poor outcome. Overall comparison of transfused(n=170) versus
nontransfused(n=198) patients by log rank analysis revealed a statistically significant adverse influence of blood transfusion on survival(p=0.0001). Forty-one percent of transfused as compared to sixty percent of nontransfused patents survived
for
5
years of more; however, after stratifying patients into stages and applying cox regression analyses, blood transfusion did not appear to have any effect on prognosis except stage III. It is postulated that the possible adverse influence of blood
transfusion on the survival of patients with gastric cancer is linked to other prognostic features rather than independently to the immunologic sequelae of the transfusion itself.
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