Effect of perioperative blood transfusions and infectious complications on inflammatory activation and long-term survival following gastric cancer resection

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• dc.contributor.author Puértolas-Rico, Noelia
• dc.contributor.author Osorio, Javier
• dc.contributor.author Jericó, Carlos
• dc.contributor.author Miranda Murúa, Coro
• dc.contributor.author Santamaría Gómez, Maite
• dc.contributor.author Artigau, Eva
• dc.contributor.author Galofré, Gonzalo
• dc.contributor.author Garsot, Elisenda
• dc.contributor.author Luna, Alexis
• dc.contributor.author Aldeano, Aurora
• dc.contributor.author Olona, Carles
• dc.contributor.author Molinas, Joan
• dc.contributor.author Pulido, Laura
• dc.contributor.author Gimeno, Marta
• dc.contributor.author Pera Roman, Manuel Ramón
• dc.date.accessioned 2024-03-14T14:28:31Z
• dc.date.available 2024-03-14T14:28:31Z
• dc.date.issued 2022
• dc.description.abstract Background: The aim of this study was to evaluate the impact of perioperative blood transfusion and infectious complications on postoperative changes of inflammatory markers, as well as on disease-free survival (DFS) in patients undergoing curative gastric cancer resection. Methods: Multicenter cohort study in all patients undergoing gastric cancer resection with curative intent. Patients were classified into four groups based on their perioperative course: one, no blood transfusion and no infectious complication; two, blood transfusion; three, infectious complication; four, both transfusion and infectious complication. Neutrophil-to-lymphocyte ratio (NLR) was determined at diagnosis, immediately before surgery, and 10 days after surgery. A multivariate Cox regression model was used to analyze the relationship of perioperative group and dynamic changes of NLR with disease-free survival. Results: 282 patients were included, 181 in group one, 23 in group two, 55 in group three, and 23 in group four. Postoperative NLR changes showed progressive increase in the four groups. Univariate analysis showed that NLR change > 2.6 had a significant association with DFS (HR 1.55; 95% CI 1.06−2.26; p = 0.025), which was maintained in multivariate analysis (HR 1.67; 95% CI 1.14−2.46; p = 0.009). Perioperative classification was an independent predictor of DFS, with a progressive difference from group one: group two, HR 0.80 (95% CI: 0.40−1.61; p = 0.540); group three, HR 1.42 (95% CI: 0.88−2.30; p = 0.148), group four, HR 2.85 (95% CI: 1.64−4.95; p = 0.046). Conclusions: Combination of perioperative blood transfusion and infectious complications following gastric cancer surgery was related to greater NLR increase and poorer DFS. These findings suggest that perioperative blood transfusion and infectious complications may have a synergic effect creating a pro-inflammatory activation that favors tumor recurrence.
• dc.format.mimetype application/pdf
• dc.identifier.citation Puértolas N, Osorio J, Jericó C, Miranda C, Santamaría M, Artigau E, Galofré G, Garsot E, Luna A, Aldeano A, Olona C, Molinas J, Pulido L, Gimeno M, Pera M. Effect of perioperative blood transfusions and infectious complications on inflammatory activation and long-term survival following gastric cancer resection. Cancers (Basel). 2022 Dec 26;15(1):144. DOI: 10.3390/cancers15010144
• dc.identifier.doi http://dx.doi.org/10.3390/cancers15010144
• dc.identifier.issn 2072-6694
• dc.identifier.uri http://hdl.handle.net/10230/59409
• dc.language.iso eng
• dc.publisher MDPI
• dc.relation.ispartof Cancers (Basel). 2022 Dec 26;15(1):144
• dc.rights © 2022 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
• dc.rights.accessRights info:eu-repo/semantics/openAccess
• dc.rights.uri http://creativecommons.org/licenses/by/4.0/
• dc.subject.keyword Gastrectomy
• dc.subject.keyword Gastric cancer
• dc.subject.keyword Infectious complications
• dc.subject.keyword Inflammatory markers
• dc.subject.keyword Patient blood management
• dc.subject.keyword Perioperative transfusion
• dc.title Effect of perioperative blood transfusions and infectious complications on inflammatory activation and long-term survival following gastric cancer resection
• dc.type info:eu-repo/semantics/article
• dc.type.version info:eu-repo/semantics/publishedVersion