围手术期输血对食管鳞癌食管切除术后总生存无影响：一项回顾性队列研究。

Perioperative blood transfusion has no effect on overall survival after esophageal resection for esophageal squamous cell carcinoma: A retrospective cohort study.

机构信息

Fujian Cancer Hospital, Fujian Medical University Cancer Hospital, Fuma Road, Jin'an District, Fuzhou, China.

Fujian Cancer Hospital, Fujian Medical University Cancer Hospital, Fuma Road, Jin'an District, Fuzhou, China; Fujian Provincial Key Laboratory of Tumor Biotherapy, Fuma Road, Jin'an District, Fuzhou, China.

出版信息

Int J Surg. 2018 Jul;55:24-30. doi: 10.1016/j.ijsu.2018.03.040. Epub 2018 Mar 22.

DOI:10.1016/j.ijsu.2018.03.040

PMID:29578096

Abstract

BACKGROUND

The impact of perioperative blood transfusion (PBT) on the prognosis of esophageal cancer patients remains inconclusive. The purpose of this study was to assess the association between PBT and survival in esophageal squamous cell carcinoma (ESCC) patients.

MATERIALS AND METHODS

In this retrospective study, patients with ESCC who underwent esophageal resection from January 2008 to December 2011 were analyzed. The overall survival and postoperative outcomes between PBT and non-PBT patients were compared using Cox regression and propensity score matching (PSM) analysis.

RESULTS

A total of 935 patients were enrolled in this study. Before PSM, the 5-year overall survival rates in PBT and non-PBT patients were 48.4% and 56.3% (P = 0.001), respectively. The postoperative infection rate in PBT patients was 32.32%, which exceeded the rate of 24.22% in non-PBT patients (P = 0.008). PSM created 306 pairs of patients. After PSM, the 5-year overall survival rates in PBT and non-PBT patients were 49.4% and 51.0% (P = 0.334), respectively. The postoperative infection rate in PBT patients was 31.04%, which was higher than the rate of 26.47% in non-PBT patients (P = 0.105). Multivariable Cox regression analyses showed that PBT was not an independent risk factor for overall survival (HR: 0.792, 95% CI: 0.615-1.021, P = 0.072).

CONCLUSION

Perioperative blood transfusion has no effect on the overall survival of ESCC patients.

摘要

背景

围手术期输血（PBT）对食管癌患者预后的影响尚无定论。本研究旨在评估 PBT 与食管鳞状细胞癌（ESCC）患者生存的关系。

材料与方法

本回顾性研究分析了 2008 年 1 月至 2011 年 12 月接受食管切除术的 ESCC 患者。使用 Cox 回归和倾向评分匹配（PSM）分析比较 PBT 和非 PBT 患者的总生存率和术后结局。

结果

本研究共纳入 935 例患者。在 PSM 之前，PBT 和非 PBT 患者的 5 年总生存率分别为 48.4%和 56.3%（P=0.001）。PBT 患者的术后感染率为 32.32%，高于非 PBT 患者的 24.22%（P=0.008）。PSM 产生了 306 对患者。PSM 后，PBT 和非 PBT 患者的 5 年总生存率分别为 49.4%和 51.0%（P=0.334）。PBT 患者的术后感染率为 31.04%，高于非 PBT 患者的 26.47%（P=0.105）。多变量 Cox 回归分析显示，PBT 不是总生存的独立危险因素（HR：0.792，95%CI：0.615-1.021，P=0.072）。