In this study, doctors from New York assessed the interaction of splenectomy and perioperative blood transfusions in patients undergoing resection of proximal gastric and gastroesophageal junction cancer.
Reports have suggested that the immunosuppressive effects of transfusions are dependent on the presence of an intact spleen.
The doctors evaluated 240 patients who underwent complete resection (R0) of proximal gastric or GEJ cancer, between 1985 and 2001.
Clinical and pathologic factors were collected in a prospective database.
Median follow-up was 25 months.
Median relapse-free survival was 30 months, and median disease-specific survival was 45 months.
|Median relapse-free survival was 30 months.|
|Journal of Clinical Oncology|
The team found that univariate analysis suggested an interaction of splenectomy and perioperative transfusion, which influenced relapse-free survival.
Patients who received a perioperative transfusion but not splenectomy had the worst prognosis on multivariate analysis.
In patients who underwent splenectomy, perioperative transfusion had no effect on relapse-free survival.
Dr Jürgen Weitz's team concluded, "Our study suggests an interaction of blood transfusion and splenectomy in their effect on survival paralleling the findings in the transplantation literature".
"The adverse effect of allogeneic blood transfusion on prognosis in patients with gastric cancer seems to be associated with the presence of an intact spleen and is abrogated by its absence".