胃癌手術時の輸血と予後との関係

抄録

Relation between perioperative blood transfusion and prognosis after surgery for gastric cancer was studied retrospectively on 2086 patients who had undergone histologically curative operation in the 2nd study of Cooperative Study Group of Surgical Adjuvant Chemotherapy for Gastric Cancer. These patients were divided into the 3 groups according to the administraiton of anticancer drugs (A: MMC, B: MMC+FT, C: FT). The survival and recurrence rate of transfused patients were compared with those of non-transfused patients in each histological stage of A, B and C groups.
Macroscopic factors of recurrence such as lymph nodal metastases, tumor size and serosal invasion in transfused patients were overestimated, and total gastrectomy with splenectomy and wide extirpation of lymph nodes were performed along with blood transfusion. But microscopic factors of recurrence in transfused patients were better than in non-transfused patients.
Five-year actuarial survival rate in transfused patients was generally lower than in non-transfused patients. Especialy the 5-year survival rates of transfused patients in stage II of A, C groups and stage III of A, B groups were respectively lower than those of non-transfused patients. Five-year actuarial recurrence rate in transfused patients was higher than in non-transfused patients. The 5-year recurrence rates of transfused patients in stage I of A, B groups, stage II of A group and stage III of B group were severally higher than those of non-transfused patients. Those rates were statistically significant.