Impact of perioperative allogeneic erythrocyte transfusion on prognosis of patients with esophageal cancer

Objective: To evaluate the impact of perioperative allogeneic erythrocyte transfusion on shortterm response and the survival of patients with esophageal cancer after surgical treatment. Methods: The clinicopathologic information and survival data from 345 consecutive patients with esophageal cancer who underwent esophagectomy were analyzed retrospectively. These 345 patients were assigned into perioperative allogeneic erythrocyte transfusion group (n = 167, the patients received perioperative allogeneic erythrocyte transfusion) and no-perioperative erythrocyte transfusion group (n = 178, the patients did not receive perioperative allogeneic erythrocyte transfusion). The survival analysis was performed using log-rank test and COX regression model. Results: The rate of perioperative complications in perioperative allogeneic erythrocyte transfusion group was significantly higher than that in no-perioperative erythrocyte transfusion group (40.7% vs 24.2%, P = 0.001), and the perioperative mortality was not obviously different between these two groups (1.8% vs 1.1%, P = 0.943). The 1-, 3- and 5-year overall survival rates of patients were 65.2%, 33.1% and 27.6%, respectively in perioperative allogeneic erythrocyte transfusion group, and 75.4%, 43.7% and 37.3%, respectively in no-perioperative erythrocyte transfusion group. There was a significant difference between these two groups (P = 0.022). Multivariate analysis revealed that pathologic grading, depth of tumor invasion, tumor thrombosis and perioperative allogeneic erythrocyte transfusion were independent risk factors for long-term survival of patients with esophageal cancer. Conclusion: Perioperative allogeneic erythrocyte transfusion is one of the prognostic factors for patients with esophageal cancer. Every efforts should be made to assure complete resection for patients receiving esophagectomy and also avoid perioperative allogeneic erythrocyte transfusion during perioperative period.