Influence of blood transfusion on postoperative inflammation, stress markers, and prognosis in patients with gastric cancer.

BACKGROUND: Perioperative blood transfusion is common in gastric cancer surgery, yet its impact on postoperative inflammation, stress response, and long-term prognosis remains incompletely understood. AIM: To investigate the effect of perioperative blood transfusion on postoperative inflammation and stress markers, as well as its correlation with prognosis in patients with gastric cancer undergoing radical gastrectomy. METHODS: A retrospective analysis was conducted on 200 patients who underwent gastric cancer surgery, divided into a non-transfusion group (n = 108) and a transfusion group (n = 92). Baseline characteristics, pathological features, postoperative inflammatory and stress markers, complications, and long-term survival were compared between the two groups. Statistical analyses were performed using t-tests, χ (2) tests, and multivariate Cox regression analysis. RESULTS: The transfusion group had a lower T-stage distribution and higher intraoperative blood loss than the non-transfusion group (P < 0.05). Postoperative inflammatory markers such as white blood cell count, neutrophil/lymphocyte ratio, C-reactive protein, interleukin-6, and stress markers like cortisol and adrenaline were significantly higher in the transfusion group than in the non-transfusion group (P < 0.05). The incidence of postoperative complications was also higher in the transfusion group than in the non-transfusion group. Overall survival (OS) and disease-free survival (DFS) were significantly shorter in the transfusion group (P < 0.05) than in the non-transfusion group. Multivariate Cox regression analysis showed that transfusion had a negative impact on OS and DFS. CONCLUSION: Perioperative blood transfusion is associated with increased postoperative inflammation, stress reactions, complication rates, and adverse prognosis in patients with gastric cancer. Reducing unnecessary transfusions can improve postoperative recovery and long-term prognosis.