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World Journal of Surgery

, Volume 41, Issue 1, pp 208–215 | Cite as

Allogenic Blood Transfusion is Associated with Poor Perioperative and Long-Term Outcome in Esophageal Cancer

  • Matthias ReehEmail author
  • Tarik Ghadban
  • Josephine Dedow
  • Eik Vettorazzi
  • Faik G. Uzunoglu
  • Michael Nentwich
  • Stefan Kluge
  • Jakob R. Izbicki
  • Yogesh K. Vashist
Original Scientific Report

Abstract

Background

Esophageal resection for cancer (EC) is still associated with considerable mortality and morbidity rates. Allogenic blood transfusion (aBT) is associated with poor short-term and long-term outcome in surgical oncology. We aimed to evaluate the effect of aBT in a homogeneous population of EC patients undergoing esophagectomy without perioperative treatment.

Methods

We analyzed 565 esophagectomies performed due to EC. Allogenic blood transfusion was correlated to clinicopathological parameters, perioperative mortality and morbidity as well as the long-term outcome. Results are presented as adjusted odds ratio (OR) or hazard ratio (HR) with 95 % confidence interval (95 % CI).

Results

Patients receiving aBT (aBT(+)) had no higher tumor stages or higher rates of lymph node metastasis (P = 0.65 and 0.17, respectively) compared to patients without aBT (aBT(−)). Allogenic blood transfusion was strongly associated with perioperative morbidity (OR 1.9, 95 % CI 1.1–3.5, P = 0.02) and mortality (OR 2.9, 95 % CI 1.0–8.6, P = 0.04). Tumor recurrence rate was significantly higher in aBT(+) patients (P = 0.001). The disease-free and overall survival were significantly longer in aBT(−) compared to aBT(+) patients (P = 0.016 and <0.001, respectively). Patients receiving aBT had almost doubled risk for tumor recurrence (HR 1.8, 95 % CI 1.2–2.5, P = 0.001) and death (HR 2.2, 95 % CI 1.5–3.2, P < 0.001).

Conclusion

Allogenic blood transfusion has a significant impact on the natural course of EC after complete resection. The poor short-term and long-term outcome warrants further evaluation of the underlying molecular mechanisms induced by allogenic blood transfusion in cancer patients.

Keywords

Overall Survival Esophageal Cancer Clinicopathological Parameter Esophageal Resection Allogenic Blood Transfusion 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Abbreviations

aBT

Allogenic blood transfusion

AC

Adenocarcinoma

AJCC

American Joint Committee on Cancer

autoBT

Autologous blood transfusion

CD

Cluster of differentiation

CI

Confidence interval

DFS

Disease-free survival

EC

Esophageal cancer

HR

Hazard ratio

OR

Odds ratio

OS

Overall survival

SCC

Squamous cell carcinoma

TA

Thoracoabdominal

TH

Transhiatal

TRICC

Transfusion requirements in critical care

WBC

White blood cell

Notes

Compliance with ethical standards

Conflict of interest

None.

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Copyright information

© Société Internationale de Chirurgie 2016

Authors and Affiliations

  • Matthias Reeh
    • 1
    Email author
  • Tarik Ghadban
    • 1
  • Josephine Dedow
    • 1
  • Eik Vettorazzi
    • 2
  • Faik G. Uzunoglu
    • 1
  • Michael Nentwich
    • 1
  • Stefan Kluge
    • 3
  • Jakob R. Izbicki
    • 1
  • Yogesh K. Vashist
    • 1
  1. 1.Department of General, Visceral and Thoracic SurgeryUniversity Medical Center Hamburg-EppendorfHamburgGermany
  2. 2.Department of Biometry and EpidemiologyUniversity Medical Center Hamburg-EppendorfHamburgGermany
  3. 3.Department of Intensive CareUniversity Medical Center Hamburg-EppendorfHamburgGermany

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