Moriguchi S, Maehara Y, Akazawa K, Sugimachi K, Nose Y
Department of Medical Informatics, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
Cancer. 1990 Dec 1;66(11):2331-5. doi: 10.1002/1097-0142(19901201)66:11<2331::aid-cncr2820661113>3.0.co;2-h.
To better comprehend the relationship between perioperative blood transfusion and survival time after curative gastrectomy for advanced gastric cancer, the authors reviewed retrospectively data on 568 patients treated in their clinics from 1965 to 1983. Of these 568, 195 (34.3%) required no blood transfusion and 373 (65.7%) required transfusions within the perioperative period. Univariate analysis indicated that the survival time of the transfusion recipients was significantly less than that of the patients who had no transfusions (P less than 0.01). In subgroups of the authors' patients stratified to adjust for stage of disease, there was, however, no significant difference between the survival rates. Subsequently, multivariate analysis, using the Cox regression analysis, which adjusted for sex, age, and other covariates, indicated that perioperative blood transfusion was not a useful factor for predicting survival time. Multivariate analysis suggested that tumor size (P less than 0.01), degree of invasion into the gastric wall (P less than 0.01) and status of lymph node metastasis (P less than 0.01) were the most important covariates after curative gastrectomy for advanced gastric cancer. The authors' findings revealed the lack of any relationship between perioperative blood transfusion and survival time of patients who underwent curative resection for advanced gastric cancer.
为了更好地理解进展期胃癌根治性胃切除术后围手术期输血与生存时间之间的关系，作者回顾性分析了1965年至1983年在其诊所接受治疗的568例患者的数据。在这568例患者中，195例（34.3%）不需要输血，373例（65.7%）在围手术期需要输血。单因素分析表明，输血患者的生存时间明显短于未输血患者（P<0.01）。然而，在作者根据疾病分期分层的患者亚组中，生存率之间没有显著差异。随后，使用Cox回归分析进行多因素分析，对性别、年龄和其他协变量进行校正，结果表明围手术期输血不是预测生存时间的有用因素。多因素分析表明，肿瘤大小（P<0.01）、胃壁浸润程度（P<0.01）和淋巴结转移状况（P<0.01）是进展期胃癌根治性胃切除术后最重要的协变量。作者的研究结果显示，进展期胃癌根治性切除患者的围手术期输血与生存时间之间不存在任何关联。
