Abstract 1472P
Background
Because of anemia on hospital admission and intra-operative blood loss, peri-operative blood transfusion(BTF) is wildly used on patients with middle and advanced stage gastric cancer (GC). The aim of this study was to investigate the potential accumulative effect of BTF and post-operative infectious on cancer-specific survival (CSS) in those GC patients after radical gastrectomy and explore the benefit from adjuvant chemotherapy(AC).
Methods
Medical records of 2114 consecutive stage II/III GC patients who underwent curative resection and planned to receive AC between November 2010 and May 2019 were retrospectively reviewed. Then, univariate and multivariate analyses were applied on the independent predictive factors with post-operative infection. At last, Cox regression analysis is used to assess the relationship among BTF, infections and CSS.
Results
Of the 2114 patients, 507 (24.0%) received peri-operative BTF and 148 (7.0%) developed post-operative infection and moreover, BTF was identified to be an independent predictor for infections. In addition, both BTF and infections independently predicted poor CSS (hazard ratio (HR): 1.193, 95% confidence interval (CI): 1.007-1.414; HR: 1.323, 95%CI: 1.013-1.727), and an accumulative effect was identified because patients with both BTF and infection were having a much shorter CSS. Additionally, based on the further stratified analyses, it is demonstrated that complete AC (≥ 6 cycles) could significantly improve CSS in patients with BTF and/or infections, which was comparable to those without BTF and/or infections (P = 0.496).
Conclusions
BTF was identified as an independent risk factor to post-infection and the reason for shorter CSS in stage II/III GC. Meanwhile, BTF and post-infections performed an accumulative effect on worse CSS. Meanwhile, complete AC could significantly improve CSS of those patients. Thus, strategies designed to ensure the completion of AC should be recommended.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.