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PubMedDate not supplied

Long-term outcome of anastomosis leakage after curative resection for mid and low rectal cancer.

BACKGROUND/AIMS: The aim of this study was to evaluate the relationship of the disease recurrence and prognosis of rectal cancer with anastomosis leakage after curative low anterior resection. METHODOLOGY: The records of 566 patients with primary rectal adenocarcinoma in the Veterans General Hospital-Taipei, Taiwan between 1991 and 1997 were reviewed. Patients who did not have anastomosis (abdominoperineal resection 72, Hartmann's operation 15), did not have curative resection (62) or expired within 30 days after operation (11) were excluded from the study. Another 34 patients were excluded because they did not visit our clinic or could not be reached by telephone or questionnaire after operation. 372 patients who received restorative curative resection with a colorectal anastomosis were analyzed. The product-limit method (Kaplan-Meier) and Cox proportional hazard model were used to analyze survival rate and tumor recurrence. RESULTS: Twenty-five out of the 406 patients had anastomosis leakage after the operation. The 5-year disease-free, local recurrence-free survival of the leakage group (32.5%, 58.7%) was significantly lower than that of the non-leakage group (71%, 88.3%). The multivariate analysis showed TNM staging (p = 0.0001) and histological differentiation (p = 0.0002) were associated with overall tumor recurrence. The factors affected local tumor recurrence were TNM staging (p = 0.006) and anastomosis leakage (p = 0.014). CONCLUSIONS: These results suggested that anastomotic leakage after curative rectal surgery is associated with the local tumor recurrence-free survival rate even after adjusting for stage.

Actuarial Analysis↗
PubMed1992

[Evaluation of endoscopic mucosal resection (EMR) as a curative therapy against early gastric cancer].

This study investigated the effectiveness of EMR as a curative therapy against early gastric cancer, comparing with that of radical operation. In 256 radical operation cases, five year survival rates were 97.5% in m-cancer and 93.2% in sm-cancer. In these cases, postoperative complications occurred in 7.8%, with operative mortality being 0.78%. In 56 EMR cases, nine encountered slight bleeding, which was controlled by ethanol injection under endoscopy. Regarding prognosis of EMR, cancer recurrences occurred in 45.8% of cases with stump involvement in the resected mucosa (stump (+)). In cases without stump involvement in the resected mucosa (stump (-)), no recurrence were found except one case, in which distance from the cancer edge to the stump was only 0.6 mm, suggesting that enough distance (2mm) to the stump is required for curative EMR. Stump (-) rate was high (81.2%) in cases of small cancer less than 1 cm in diameter, but was low in cases of cancer greater than 2 cm and those located in upper body or lesser curvature. To establish EMR as a curative therapy, it must be performed by single collection to check remaining cancer. In conclusion, although radical operation is still the standard curative therapy, EMR should be considered as an alternative therapy.

Aged↗
PubMed2004

Postoperative follow-up strategies for patients after potentially curative surgery for colorectal cancer at Christchurch Hospital.

AIM: To describe the follow-up patterns of patients with colorectal cancer (CRC) having had surgery with curative intent. METHODS: A retrospective study was undertaken of follow-up patterns in patients who had undergone 'curative' surgery for colorectal cancer at Christchurch Hospital from 1 January 1996 to 31 December 2000. Patients were identified from three sources: the General Surgical Audit Database (Otago system), the hospital clinical Casemix DRG Database, and the Oncology Service database. Patients were included only if they had surgery with curative intent, within the stated period, and had follow-up at Christchurch Hospital. Data extracted included: patient demographics, details of initial surgery, adjuvant therapies, recurrences, and details of follow-up arrangements (including investigations). RESULTS: Of 893 patients coded as having CRC, 284 patients met the inclusion criteria. Patients were excluded for the following reasons: no operation (64), operation before 1996 (18), palliative surgery (345), previous cancer (55), no cancer (32), died within 30 days of surgery (26), follow-up outside of Christchurch region (39), and notes unavailable (30). The median age was 72 (range 28.6-99.9 years). Median follow-up time was 732 days. Most patients (91%) were followed-up by their surgeon. Patients had an average of 2.6 visits to their specialist in the first year of follow-up. Unplanned clinic visits accounted for 8.3% of all clinic visits--resulting in a number of unplanned investigations. During the follow-up period, patients had 112 colonoscopies, 68 CT scans, 8 abdominal ultrasounds, and 7 barium enemas. Recurrence was detected in 58 patients (20.4%); 23 (39.7%) recurrences were detected in the first year of follow-up. Of the 279 patients who had some form of follow-up, 9 asymptomatic patients had recurrent disease (detected as a result of a planned clinic visit) and had a potentially curative procedure for recurrence. CONCLUSIONS: The number of visits per year correlated closely with the earlier findings of Connor et al,4 however the number of investigations carried out was variable and substantially less than had been reported. Follow-up visits have limited value for the detection of asymptomatic potentially curable recurrent disease.

Adult↗
PubMed2004

[Significance of serum anti-Clq Ab in evaluation of lupus nephritis activity and its curative effects of pharmacotherapy on lupus nephritis].

OBJECTIVE: To investigate the significance of serum anti-C1q Ab of evaluation of lupus nephritis activity and its curative effects of cyclophophamide therapy on lupus nephritis (LN). METHODS: The level of serum anti-C1q antibody of 75 patients with LN was examined by enzyme-linked immunosorbent assay (ELISA) of the 75 patients the incipient cases had never received corticosteroid and immunosuppressant and the recurrent cases had stopped the immunosuppressant treatment for more than 3 months and were treated, if so, with prednisone with the dosage </= 10 mg/d. Thirty-one patients underwent renal biopsy. The patients underwent treatment of cyclophophamide. The relationships between serum anti-C1q Ab level and lupus nephritis activity, renal pathohistology, as well as laboratory parameters were analyzed, followed by further regular follow-up to investigate its influence to the curative effect. RESULTS: Fifty-five of the 75 patients (73.3%) were anti-C1q Ab positive with the level of (92 U/ml +/- 41 U/ml). The mean time of conversion of urinary protein into negative was 9 months in the positive C1q positive group and 6 months in the C1q negative group. One year after, 25% of those with positive C1q antibody failed to convert into urinary protein negative, and 90% of those with negative C1q antibody converted into urinary protein negative. One year after, 32% of those whose serum C1q antibody remained positive 1 month after the treatment failed to convert into urinary protein negative, and 91% of those whose serum C1q antibody remained positive 1 month after the treatment converted into urinary protein negative. The serum anti-C1q Ab level was positively correlated with the lupus nephritis clinical active index, proteinuria, and titer of anti-dsDNA, and was negatively correlated with the levels of serum C3 and C4. Renal biopsies showed a positive correlation between the serum anti-C1q Ab level and the activity index of renal pathohistology. Multivariate analysis showed that the serum anti-C1q Ab level after treatment were associated with the curative effect and prognosis of LN. CONCLUSION: Serum anti-C1q Ab is not only a good index of lupus nephritis activity, but also reflects renal involvement and curative effect. That serial measurement of serum anti-C1q Ab may provide better clinical strategies for the therapy.

Adult↗
PubMed2006

[Characteristics of metastasis and recurrence following curative resection for colonic carcinoma].

OBJECTIVE: To investigate the characteristics of metastasis and recurrence following curative resection for colonic carcinoma,and analyze the prognosis. METHODS: The clinicopathological and follow-up data of 310 patients with colon carcinoma undergoing curative resection were analyzed retrospectively. RESULTS: The recurrence rate after curative resection was 23.2% (72/310). The 5-year survival rate was 64.6%. Hepatic metastasis accounted for 38.9% of the cases. Gross classification,histological type, differentiation, lymph node metastasis were correlated with metastasis/recurrence. Univariate analysis revealed that gross classification, histological type, differentiation, lymph node metastasis, blood vessel invasion, TNM Stage, postoperative chemotherapy, portal chemotherapy were prognostic factors. Cox regression analysis revealed that only gross classification, lymph node metastasis, postoperative chemotherapy, portal chemotherapy were independent prognostic factors. CONCLUSIONS: Liver is the most common metastatic site after curative resection for colonic carcinoma. Gross classification, lymph node metastasis, postoperative chemotherapy, and portal chemotherapy are independent prognostic factors.

Adult↗
PubMed2006

Differential roles of 18F-FDG PET in patients with locoregional advanced nasopharyngeal carcinoma after primary curative therapy: response evaluation and impact on management.

UNLABELLED: This prospective study compares the efficacies of whole-body (18)F-FDG PET and a conventional work-up (CWU) in evaluating the treatment response for patients with locoregional advanced nasopharyngeal carcinoma (NPC) after primary curative therapy and investigates the impact of PET on patient management. METHODS: Patients who had locoregional advanced NPC (stages III and IVa-b, staged by (18)F-FDG PET and CWU) and who had completed primary curative therapy for 3 mo were enrolled. The curative therapy consisted of concurrent chemoradiotherapy with or without induction chemotherapy. All of the patients also underwent (18)F-FDG PET and CWU to evaluate the response. The criteria for final diagnosis were based on pathology or subsequent follow-up for at least 6 mo. Rates of detection by (18)F-FDG PET and CWU and the impact on management were determined on site and patient bases, respectively. RESULTS: From January 2002 to August 2005, 131 patients with NPC were eligible, including 71 patients with stage III NPC (group A) and 60 patients with stage IVa-b NPC (group B). Twelve patients were proven to have residual tumors. (18)F-FDG PET had a higher overall sensitivity than CWU in group A (100% vs. 25%) and group B (91.7% vs. 58.3%). The overall specificity of PET was significantly higher than that of CWU in group B (97.6% vs. 91.7%; P = 0.019) but was slightly lower in group A (95.7% vs. 96.7%). The overall accuracy of PET also was significantly higher than that of CWU in group B (97.2% vs. 89.4%; P = 0.002) but was similar to that of CWU in group A (95.8% vs. 95.3%). PET resulted in management changes in 11 patients (15.4%; 11/71) in group A, with positive and negative impacts on 3 and 8 patients, respectively. In group B, the management of 26 of 60 patients (43%) was changed as a result of PET and included positive impacts on 23 patients and negative impacts on 3 patients. CONCLUSION: (18)F-FDG PET plays differential roles in patients with stage III NPC and stage IVa-b NPC after primary curative therapy. PET has higher sensitivity and specificity in evaluating the response and results in better management of patients with stage IVa-b NPC. PET has a less prominent impact on patient management but higher sensitivity in patients with stage III NPC.

Female↗
PubMed1989

Observation on the curative effect of 120 cases of auditory hallucination treated with auricular acupuncture.

Auditory hallucination often affects the thinking and emotion of the patients leading to dangerous behaviour of injuring themselves or others. We have treated auditory hallucination with different kinds of psychosis, mainly using auricular acupuncture and yielding certain curative effect. In our series, we found that there is no obvious correlation between number of attacks and the curative effect; however the duration of each attack may affect the curative effect. We also noticed that there is no significant difference in curative effects among the groups of simple auricular acupuncture, auricular plus body acupuncture and auricular acupuncture plus chlorpromazine. Therefore, we recommend auricular acupuncture for treating auditory hallucination.

Acupuncture Therapy↗
PubMed1989

[Relative non curative resection of gastric cancer].

Relative non curative resection of gastric cancer was studied according to The General Rules of Japanese Research Society for gastric cancer. The five year survival rate was 31.2%, while 39.6% for relative curative resection and 4.9% for absolute non curative resection. The cases whose relative non curative factor was due to lymph nodes (n greater than R) resulted in a fair prognosis, but the prognosis of those concerned with peritoneal dissemination (P1) or liver metastasis (H1) was very poor. Surgical achievement to improve postoperative results may be obtained when a systemic (13), (14v) (16) lymph node dissection is performed whenever only one of them was involved in metastasis.

Gastrectomy↗
PubMed1984

Curative local excision in the treatment of carcinoma of the rectum.

A safe, simple technique of curative local excision is used for early invasive carcinoma of the rectum. Strict criteria were applied in selecting patients for curative local excision: (1) the tumor was less than 3 cm in diameter; (2) there were no clinically involved pelvic lymph nodes; (3) the tumor had a pedicle or pseudopedicle, and (4) subsequent histopathologic examination showed that the tumor was confined to the mucosa and submucosa of the bowel wall and completely excised. Curative local excision in 16 patients had no operative mortality or morbidity. The five-year cancer specific survival was 100 per cent, which compares favorably with the 88 per cent cancer specific survival rate in 268 patients managed by conventional curative resection for Dukes' stage A tumors. When the 7.1 per cent operative mortality of resection was additionally considered, the five-year survival fell to 81 per cent. The probability of lymph-node metastases in primary rectal tumors confined to the mucosa and submucosa was found to be 6.2 per cent irrespective of their diameter, i.e., slightly less than the mortality of resection.

Aged↗
PubMed1993

[Curative effect of combined traditional Chinese medicine with Western medicine therapy on chronic nephritis and its correlation with hemorheology and microcirculation].

Patients were divided into two groups, 89 cases treated by combined traditional Chinese and Western medicine (TCM-WM) therapy, the other 36 served as control. Each of two groups was further subdivided into 4 clinical types and 5 Syndromes of TCM. Hemorheology and microcirculation were tested before and after treatment, the clinical curative effects of both groups were compared and correlation analysis between clinical curative effect and improvement of hemorheology and microcirculation was made. The results showed that the remission rate and total effective rate were 79.8% and 92.1% respectively in testing group, significantly higher than those (25% and 50%) of control (P < 0.05-0.01). The curative effect on each clinical type and Syndrome of TCM was better than that on corresponding type and Syndrome of control (P < 0.05-0.01). The improvement of hemorheology and microcirculation was more significant in testing group than that in control. It was very significant in complete and partial remission of both group (P < 0.05-0.01) but not marked in the cases of improved and ineffective cases (P > 0.05). Therefore clinical curative effect was closely related with them. So any treatment which could improve hemorheology and microcirculation would be useful in treating chronic nephritis.

Adult↗
PubMed1996

[Possibilities and limitations of curative resections in cancers of the pancreas].

Univariate and multivariate analysis was used to assess the potential and limitations of curative resection in cancer of the pancreas. From 1971 to 1993, we operated 466 patients with cancer of the pancreas, using tumor resection in 192 cases. Among these, 40% required resection of the vessels or neighboring organs allowing RO resection in 85% of the patients. The most valuable prognostic factor was curative resection, followed by tumor grading and tumor size. Non-curative tumor resection did not improve survival over exploratory laparotomy or palliative anastomoses. Operative mortality after resection was lower than for procedures leaving the tumor in situ. Extended resection with vessel resection had no effect unless combined with local curative ablation, but cannot be indicated in cases with synchronous metastases or invasion of the neighboring organs. Preoperative explorations do not provide a precise indication of extension in cancer of the pancreas which can only be evaluated in an open procedure by an experienced surgeon.

Adenocarcinoma↗
PubMed1996

[Surgical therapy and prognosis of not curatively resectable rectum carcinoma. Results of a multicenter study of the Colorectal Carcinoma Study Group].

The prospective multicenter observation study of the SGCRC found in 1121 rectal carcinomas a resection rate of 94.2% with 79.1% curative resections (R0), 3.1% R1 resections and 11.7% R2 resections. The reasons for non-curative resections were multimorbidity preventing tumor resection, distant metastasis or locally advanced primary tumors. The prognosis following non curative surgery for rectum carcinoma depends on resectability, synchrone distant metastases and R classification (according to UICC). Additional therapy (chemo- and radiotherapy) may improve short time survival after non-curative resections in presence of distant metastases. After non-resective surgery local tumor destruction (laser, kryotherapy) is possibly an useful additional therapy. The indications for multimodal therapies are discussed and the development of uniform therapeutical strategies is required.

Adult↗
PubMed1997

A phase III randomized study of interleukin-2 lymphokine-activated killer cell immunotherapy combined with chemotherapy or radiotherapy after curative or noncurative resection of primary lung carcinoma.

BACKGROUND: Adoptive immunotherapy with interleukin-2 (IL-2) and lymphokine-activated killer (LAK) cells has resulted in response among some patients with advanced malignant disease. However, the relative therapeutic benefit of adoptive immunotherapy as an adjuvant to surgery has not been determined. METHODS: A Phase III prospective randomized controlled study of adjuvant immunotherapy combined with chemotherapy or radiotherapy was conducted for 174 primary lung carcinoma patients postsurgically. After a pathologic examination of resected tissues, patients were divided into curative and noncurative cases and randomized to receive either combined immunotherapy (Group A) or control standard therapy (Group B). Patients who had undergone curative resection of lung carcinoma were stratified according to the stages and histologic types of their disease, and those who had undergone noncurative resection were stratified according to the causes of noncurative resection. The patients of Group A received IL-2 and LAK cells after either chemotherapy or radiotherapy, and those in Group B received either no adjuvant therapy (curative cases) or radiotherapy or chemotherapy alone (noncurative cases), according to the causes of noncurative resection. RESULTS: The 5- and 9-year survival rates of the Group A patients were 54.4% and 52.0%, respectively, and those of the Group B patients were 33.4% and 24.2%, respectively. The difference was statistically significant (P < 0.001, according to the generalized Wilcoxon's test and the Cox-Mantel test). The difference was also statistically significant in the curative cases (65.5% for Group A vs. 40.6% for Group B; 5-year survival rate, P < 0.01), noncurative cases (43.0% for A vs. 20.8% for B; P < 0.01), adenocarcinoma cases (47.5% for A vs. 23.0% for B; P < 0.05), and squamous cell carcinoma cases (62.1% for A vs. 34.8% for B; P < 0.01). CONCLUSIONS: Adoptive immunotherapy with IL-2 and LAK cells combined with chemotherapy or radiotherapy improved the survival of patients after surgical resection of primary lung carcinoma. A multi-institutional group study should be carried out to verify the significance of this study.

Adult↗
PubMed1994

Routine long-term follow-up in patients treated with curative intent for squamous cell carcinoma of the larynx, pharynx, and oral cavity. Does it make sense?

OBJECTIVE: To evaluate whether additional curative treatment was possible in patients for whom routine long-term follow-up had led to the early detection of locoregional recurrence, distant metastases, and second primary tumors (events). DESIGN: Cohort study with a maximum follow-up of 126 months and a consensus questionnaire. SETTING: Department of Head and Neck Oncology at the University Hospital Nijmegen (the Netherlands). PATIENTS: There were 428 patients treated with curative intent for carcinoma of the larynx, pharynx, and oral cavity from 1979 to 1983. MAIN OUTCOME MEASURES: Site, stage, differentiation grade, and type of treatment of index tumor (routine follow-up vs self-referral). RESULTS: There were 205 patients (47.9%) who developed events, 76.1% within 3 years of initial treatment. Eighty-nine patients (43.4%) received curative treatment. The detection rate for events during routine follow-up (6350 appointments) was one in 34, and for self-referrals (54) it was one in 2.7; the cure rates were one in 78 and one in 6.8, respectively. The mean survival after detection of events with routine follow-up was significantly (P < .05) better than with self-referral (58 vs 32 months, respectively). CONCLUSIONS: Routine follow-up is indispensible. Site and stage of the index tumor played a part in the length of routine follow-up, in contrast to the differentiation grade or type of initial treatment. Yearly chest roentgenograms were valuable only for laryngeal index tumors. Patients considered routine follow-up important; however, negative findings at physical examination of complaints did not reassure all patients.

Adolescent↗
PubMed2000

Intra-arterial iodine 131-labeled lipiodol as adjuvant therapy after curative liver resection for hepatocellular carcinoma: a phase 2 clinical study.

HYPOTHESIS: Intra-arterial lipiodol labeled with iodine 131 ((131)I-lipiodol) can be safely used as adjuvant therapy following curative liver resection for hepatocellular carcinoma (HCC). DESIGN: Phase 2 pilot study. SETTING: Large teaching hospital. PATIENTS: Twenty-eight patients (24 men and 4 women; median age, 61.5 years; range, 33-75 years) were treated from January 1991 to June 1997. The liver was cirrhotic in 7 cases and noncirrhotic in 21 cases. An equal number of 14 patients underwent a major and a minor resection, all with clear margins. Median diameter of solitary tumors or the larger tumor when multiple tumors occurred was 5.5 cm (range, 2.5-29 cm). Tumor encapsulation was present in 12 cases and absent in 16 cases. After informed consent, patients who had no evidence of residual or recurrent tumor on computed tomographic (CT) scan and no sign of liver failure 2 to 3 months after curative resection for HCC were included in the trial. Complete follow-up was obtained (median, 51 months; range, 5-93 months). INTERVENTIONS: A 1110-MBq dose of (131)I-lipiodol was administered into the hepatic artery using the Seldinger technique. Patients were kept in a radio-protected room for 5 days. Postinjection radioactive whole scintiscan was performed at 5 days and an abdominal CT scan at 1 month after the injection. A second injection was performed in 16 patients 2 years later using the same protocol. MAIN OUTCOME MEASURE: Procedure safety. RESULTS: All patients experienced transient fever during the first 12 hours following injection. There were no noted adverse clinical effects or significant alteration in hepatic function due to the procedure or at immediate and late follow-up. The radioactive scan demonstrated an intense liver uptake, which was homogeneous in 19 cases and heterogeneous in 9. Mild detectable thyroid and lung uptake occurred in 50% of cases. No lipiodol liver fixation was observed on the 1-month CT scan. At the time of follow-up, 6 patients had died and 12 had developed recurrences, with 5 of the 6 deaths belonging to the recurrent group. Sixteen patients remained disease free. The median time to detected recurrence was 28 months (range, 12-62 months). Overall survival rates were 86% at 3 years and 65% at 5 years. CONCLUSIONS: This pilot study failed to demonstrate any clinically significant adverse effect of adjuvant therapy by intra-arterial (131)I-lipiodol after curative liver resection for HCC. Long-term survival compares favorably with those undergoing only surgery and suggests a benefit in lowering tumor recurrence. A randomized, multicenter, prospective trial comparing patients treated with intra-arterial (131)I-lipiodol with a nontreated control group seems appropriate.

Carcinoma, Hepatocellular↗
PubMed1987

Influence of the extent of resection on survival after curative treatment of gastric carcinoma. A retrospective multivariate analysis.

The therapeutic value of extensive gastric resection and regional lymphadenectomy in the curative treatment of gastric adenocarcinoma is controversial. We undertook a retrospective study of 210 patients treated with curative intent from 1960 to 1980. A multivariate survival analysis using the Cox model revealed five significant variables predictive of death from gastric cancer--two inherent pathologic factors: (1) nonpyloric site and (2) metastases in more than three lymph nodes, and three treatment factors that could often be controlled by the surgeon: (3) microscopic positive gastric resection margin, (4) inadequate lymphadenectomy, and (5) total gastrectomy. These observations reaffirm the value of wide gastric resection and adequate lymphadenectomy but argue against a general policy of elective total gastrectomy in the curative treatment of gastric carcinoma.

Adenocarcinoma↗
PubMed1998

Results of 136 curative hepatectomies with a safety margin of less than 10 mm for colorectal metastases.

BACKGROUND AND OBJECTIVES: It is now established that liver resection is beneficial for metastases from colorectal cancer. Nevertheless, a surgical margin estimated at less than 10 mm at preoperative imaging is considered an absolute contraindication to surgery by some, and a relative contraindication by others. The true impact of the width of the margin on the prognosis is unclear. METHODS: From 1984 to 1996, 196 patients underwent curative hepatectomy for liver metastases and were studied prospectively. Surgery was to be curative (or a complete R0 resection) and mortality was to be avoided. Of these 196 patients, 136 had surgical margins of less than 10 mm. Sixty-eight percent had multiple liver metastases and 15% had extrahepatic metastatic lesions. Clinical and pathological factors were studied specifically and a multivariate analysis was carried out. RESULTS: Overall 5-year survival rate of these 136 patients (taking into account postoperative mortality which attained 1.5%) was 27.8% and the disease-free survival was 22.9%. The surgical margin was 0 mm in 30 cases. The sole prognostic factor was the discovery of unsuspected (resectable) extrahepatic lesions at laparotomy (P < 0.001) ; the width of the free margin had no significant effect. However, in the multivariate analysis of prognostic factors for the entire series (269 hepatectomies), three powerful parameters were identified : (1) the curative nature of resection (P = 0.0007), (2) less than 20% of liver involvement (P = 0.002), and (3) a free margin exceeding 9 mm (P = 0.02). A correlation was found between narrow margins and extensive disease (high number of metastases, bilateral sites, and extended hepatectomy). There was also a greater likelihood of microscopic satellite lesions within 10 mm around the metastases. CONCLUSIONS: The prognostic impact of the width of the surgical margin should not be overestimated. Hepatectomy for liver metastases can procure long-term survival, even in patients with supposedly poor prognostic factors. Resection is justified as long as it is complete and the risks are minimal.

Aged↗
PubMed1990

Lack of relationship between perioperative blood transfusion and survival time after curative resection for gastric cancer.

To better comprehend the relationship between perioperative blood transfusion and survival time after curative gastrectomy for advanced gastric cancer, the authors reviewed retrospectively data on 568 patients treated in their clinics from 1965 to 1983. Of these 568, 195 (34.3%) required no blood transfusion and 373 (65.7%) required transfusions within the perioperative period. Univariate analysis indicated that the survival time of the transfusion recipients was significantly less than that of the patients who had no transfusions (P less than 0.01). In subgroups of the authors' patients stratified to adjust for stage of disease, there was, however, no significant difference between the survival rates. Subsequently, multivariate analysis, using the Cox regression analysis, which adjusted for sex, age, and other covariates, indicated that perioperative blood transfusion was not a useful factor for predicting survival time. Multivariate analysis suggested that tumor size (P less than 0.01), degree of invasion into the gastric wall (P less than 0.01) and status of lymph node metastasis (P less than 0.01) were the most important covariates after curative gastrectomy for advanced gastric cancer. The authors' findings revealed the lack of any relationship between perioperative blood transfusion and survival time of patients who underwent curative resection for advanced gastric cancer.

Blood Transfusion↗