Choi J H, Chung H C, Yoo N C, Lee H R, Lee K H, Kim J H, Roh J K, Min J S, Lee K S, Kim B S
Department of Internal Medicine, Ewha Woman's University College of Medicine, Seoul, South Korea.
Oncology. 1995 Mar-Apr;52(2):170-5. doi: 10.1159/000227452.
Several reports have demonstrated an adverse effect of perioperative blood transfusions on the survival of patients with various solid tumors treated surgically. We retrospectively investigated the relationship between perioperative blood transfusions and the survival of 501 patients who underwent radical subtotal gastrectomy for locally advanced gastric cancer (stage II-IIIB) from January 1984 to December 1989. Three hundred and fifty-two patients (70.3%) received blood transfusions within the perioperative period. The transfused group included patients with tumors of larger size (5.1 vs. 4.4 cm, p = 0.001) and more advanced stage (stage IIIB: 27.6 vs. 10.7%, p = 0.0001) than the nontransfused group. Although the 5-year overall survival rate was significantly lower (52.9 vs. 66.7%, p = 0.026) in the transfused patients than the nontransfused, subgroup analysis according to the pathologic stage showed no statistically significant difference in survival in each stage between the two groups. In conclusion, we could not find any causal relationships between transfusion and prognosis in patients with curatively resected locally advanced gastric cancer. Circumstances such as advanced stage necessitating transfusions may be more important prognostic factors.
多项报告表明，围手术期输血对接受手术治疗的各种实体瘤患者的生存有不良影响。我们回顾性研究了1984年1月至1989年12月期间501例行根治性次全胃切除术治疗局部进展期胃癌（II-IIIB期）患者围手术期输血与生存之间的关系。352例患者（70.3%）在围手术期接受了输血。与未输血组相比，输血组患者的肿瘤更大（5.1 vs. 4.4 cm，p = 0.001）且分期更晚（IIIB期：27.6% vs. 10.7%，p = 0.0001）。虽然输血患者的5年总生存率显著低于未输血患者（52.9% vs. 66.7%，p = 0.026），但根据病理分期进行的亚组分析显示，两组在各阶段的生存情况无统计学显著差异。总之，我们未发现根治性切除的局部进展期胃癌患者输血与预后之间存在任何因果关系。诸如因分期较晚而需要输血等情况可能是更重要的预后因素。
