Matthias Reeh1, Tarik Ghadban2, Josephine Dedow2, Eik Vettorazzi3, Faik G Uzunoglu2, Michael Nentwich2, Stefan Kluge4, Jakob R Izbicki2, Yogesh K Vashist2. 1. Department of General, Visceral and Thoracic Surgery, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany. mreeh@uke.de. 2. Department of General, Visceral and Thoracic Surgery, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany. 3. Department of Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany. 4. Department of Intensive Care, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany.
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.
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 cancerpatients.
Authors: Wen-Chih Wu; Tracy S Smith; William G Henderson; Charles B Eaton; Roy M Poses; Georgette Uttley; Vincent Mor; Satish C Sharma; Michael Vezeridis; Shukri F Khuri; Peter D Friedmann Journal: Ann Surg Date: 2010-07 Impact factor: 12.969
Authors: Peter J Kneuertz; Sameer H Patel; Carrie K Chu; Shishir K Maithel; Juan M Sarmiento; Keith A Delman; Charles A Staley; David A Kooby Journal: Ann Surg Oncol Date: 2011-01-08 Impact factor: 5.344
Authors: Marcovalerio Melis; James M McLoughlin; E Michelle Dean; Erin M Siegel; Jill M Weber; Nilay Shah; Scott T Kelley; Richard C Karl Journal: J Surg Res Date: 2008-07-31 Impact factor: 2.192
Authors: Howard L Corwin; Andrew Gettinger; Ronald G Pearl; Mitchell P Fink; Mitchell M Levy; Edward Abraham; Neil R MacIntyre; M Michael Shabot; Mei-Sheng Duh; Marc J Shapiro Journal: Crit Care Med Date: 2004-01 Impact factor: 7.598
Authors: Alexander Kulier; Jack Levin; Rita Moser; Gudrun Rumpold-Seitlinger; Iulia Cristina Tudor; Stephanie A Snyder-Ramos; Patrick Moehnle; Dennis T Mangano Journal: Circulation Date: 2007-07-09 Impact factor: 29.690
Authors: Frederike C Ling; Arnulf H Hoelscher; Daniel Vallböhmer; Daniel Schmidt; Susanne Picker; Birgit S Gathof; Elfriede Bollschweiler; Paul M Schneider Journal: J Gastrointest Surg Date: 2009-01-17 Impact factor: 3.452
Authors: M M Lange; J A van Hilten; L M G van de Watering; B A Bijnen; R M H Roumen; H Putter; A Brand; C J H van de Velde Journal: Br J Surg Date: 2009-07 Impact factor: 6.939
Authors: Paula Marincola Smith; Jordan Baechle; Carmen C Solórzano; Marcus Tan; Alexandra G Lopez-Aguiar; Mary Dillhoff; Eliza Beal; George Poultsides; John G D Cannon; Flavio G Rocha; Angelena Crown; Clifford Cho; Megan Beems; Emily R Winslow; Victoria R Rendell; Bradley A Krasnick; Ryan C Fields; Shishir K Maithel; Christina E Bailey; Kamran Idrees Journal: HPB (Oxford) Date: 2019-12-02 Impact factor: 3.647
Authors: Leonard Angka; Sarwat T Khan; Marisa K Kilgour; Rebecca Xu; Michael A Kennedy; Rebecca C Auer Journal: Int J Mol Sci Date: 2017-08-17 Impact factor: 5.923
Authors: Kai B Kaufmann; Wolfgang Baar; Torben Glatz; Jens Hoeppner; Hartmut Buerkle; Ulrich Goebel; Sebastian Heinrich Journal: BMC Anesthesiol Date: 2019-08-22 Impact factor: 2.217
Authors: Vivienne Keding; Kai Zacharowski; Wolf O Bechstein; Patrick Meybohm; Andreas A Schnitzbauer Journal: World J Surg Oncol Date: 2018-08-07 Impact factor: 2.754