Abstract | BACKGROUND: Perioperative allogeneic blood transfusion (ABT) may be a deleterious predictor on the prognosis of gastric cancer (GC) for subjects who had undergone curative surgeries. In this article we proposed to figure out the effect of ABT with a systematic review and meta-analysis. METHODS: Relevant articles were identified by searching Pubmed and Embase to March 2014. A random-effects model or fixed-effects model was used to calculate pooled odds ratios ( ORs). Sensitivity analysis, meta-regression, stratified analysis, dose-response meta-analysis were conducted, and publication bias tested. RESULTS: Eighteen studies (9120 GC patients) were included, of which 36.3% received transfusions. ABT was associated with increased all-cause mortality (OR, 2.17; 95% confidence interval [CI], 1.72-2.74; p<0.001; I2=75%). Sensitivity analysis showed significant changes in ORs while meta-regression had little influence on ORs. Galbraith plot revealed the OR reduced to 2.10 (95% CI, 1.86-2.37; p<0.001) with tau2 reduced to 0.00 and I2 reduced to 0%. RESULTS of stratified analysis were robust and consistent. Dose-response meta-analysis revealed that all-cause mortality was significantly lower in patients transfused with ≤800 mL of blood than those transfused with >800 mL (OR, 0.58; 95% CI, 0.37-0.92; p=0.02; I2=54%). ABT was also associated with increased cancer-related mortality (OR, 2.57, p=0.011) and recurrence (OR, 1.52, p=0.017). CONCLUSIONS: In GC patients undergoing curative surgeries, ABTs are associated with a worse prognosis, including all-cause mortality, cancer-related mortality and recurrence. Patient blood management should be investigated further to minimize use of ABT.
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Authors | Chang Sun, Yi Wang, Hou Shan Yao, Zhi Qian Hu |
Journal | International journal of surgery (London, England)
(Int J Surg)
Vol. 13
Pg. 102-110
(Jan 2015)
ISSN: 1743-9159 [Electronic] England |
PMID | 25486261
(Publication Type: Journal Article, Meta-Analysis, Research Support, Non-U.S. Gov't, Review, Systematic Review)
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Copyright | Copyright © 2014 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved. |
Topics |
- Blood Transfusion
(mortality)
- Cause of Death
- Humans
- Neoplasm Recurrence, Local
- Odds Ratio
- Prognosis
- Risk Factors
- Stomach Neoplasms
(mortality, surgery)
- Transfusion Reaction
- Treatment Outcome
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