Prognostic impact of allogenic blood transfusion following surgical treatment of esophageal cancer
- 2 Downloads
Esophageal cancer (EC) surgery is associated with relatively high morbidity and mortality rates and poor overall survival (OS). The impact of allogeneic blood transfusion (aBT) on OS is still a matter of debate. We aimed to investigate the impact of aBT on OS in a homogeneous population of patients undergoing surgical treatment for EC in a single center during a 15-year period.
In total, 409 patients who had undergone surgical resection for EC were studied. The clinicopathological parameters and OS were compared between 170 patients (41.6%) who received perioperative aBT and 239 patients (58.4%) who did not.
Compared with the non-transfused patients, patients who received aBT had lower preoperative hemoglobin levels, more comorbidities, and a more advanced stage of disease as reflected by tumor diameter, nodal metastases, perineural invasion, and the need for multiorgan resection. Transfused patients suffered more frequently from major postoperative complications (26/170 [21.5%] vs. 13/239 [5.7%], p < 0.001) and had a significantly longer hospital stay (17 vs. 15 days, p < 0.001). Multivariate analysis identified tumor grade (p = 0.02), perineural invasion (p = 0.001), N stage (p < 0.001), major postoperative complications (p = 0.01), and comorbidity (p = 0.04) as independent predictors of OS in patients with EC. Perioperative aBT was not found to be an independent predictor of OS in the entire cohort, neither in the stratified subanalysis.
In our study, an advanced stage of disease and comorbidities resulted in the need for blood transfusion and the occurrence of major postoperative complications, which appeared to decrease the OS in patients with EC.
KeywordsOutcome Esophagectomy Overall survival Squamous cell carcinoma Adenocarcinoma
Allogeneic blood transfusion
Adenocarcinoma of the esophagogastric junction
Packed red blood cells
Conflict of interest
D. Velickovic, P. Sabljak, D. Stojakov, J. Velickovic, K. Ebrahimi, V. Sljukic, and P. Pesko declare that they have no competing interests.
- 1.GBD 2015 Disease and Injury Incidence and Prevalence Collaborators. Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980–2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet. 2016;388:1459–544.CrossRefGoogle Scholar
- 2.GBD 2015 Disease and Injury Incidence and Prevalence Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet. 2016;388:1545–602.CrossRefGoogle Scholar
- 9.Boshier PR, Ziff C, Adam ME, et al. Effect of perioperative blood transfusion on the long-term survival of patients undergoing esophagectomy for esophageal cancer: a systematic review and meta-analysis. Dis Esophagus. 2018;31:1–10.Google Scholar
- 10.Lee J, Chin JH, Kim JI, et al. Association between red blood cell transfusion and long-term mortality in patients with cancer of the esophagus after esophagectomy. Dis Esophagus. 2017;31:1–8.Google Scholar