ArticleBMC cancer2023
Pre-operative anemia and peri-operative transfusion are associated with poor oncologic outcomes in cancers of the esophagus: potential impact of patient blood management on cancer outcomes.
Article in BMC cancer, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- Article
- Impact of Chronic Kidney Disease Stages 3-5 on Mortality and Morbidity Outcomes in Patients with Esophageal Cancer: A Propensity-Score-Matched Cohort Study.Current oncology (Toronto, Ont.) · 2026Article
- Impact of preoperative anemia on postoperative rate of severe complications and short-term clinical outcomes after retroperitoneal tumor resection.BMC anesthesiology · 2025Article
- Preoperative red blood cell transfusion improves treatment response and survival in patients with locally advanced esophageal cancer and iron deficiency anemia.American journal of cancer research · 2025Article
- TAVAC: comprehensive review of currently available hemostatic products as adjunct to surgical hemostasis.Surgical endoscopy · 2024Review
- The Usefulness of the Modified Advanced Lung Cancer Inflammation Index (mALI) as a Prognostic Factor in Patients With Esophageal Cancer who Have Undergone Curative Resection.In vivo (Athens, Greece)Article
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Authors and funding
6 authors.
Funding
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Abstract
backgroundBoth Red Blood Cell (RBC) transfusion and anemia are thought to negatively impact cancer survival. These effects have been reported with mixed findings in cancer of the esophagus. The potential impact of the application of restrictive transfusion strategies on this patient population has not been defined. MATERIALS AND
methodsWe conducted a retrospective study of esophagectomies and studied cases based on whether they were anemic or were transfused peri-operatively. Clinical characteristics and known clinicopathologic prognosticators were compared between these groups. Survival was compared by Cox proportional hazard modeling. Post-operative transfusions were assessed for compliance with restrictive transfusion thresholds.
resultsThree-hundred ninety-nine esophagectomy cases were reviewed and after exclusions 348 cases were analyzed. The median length of follow-up was 33 months (range 1-152 months). Sixty-four percent of patients were anemic pre-operatively and 22% were transfused. Transfusion and anemia were closely related to each other. Microcytic anemia was uncommon but was evaluated and treated in only 50% of cases. Most anemic patients had normocytic RBC parameters. Transfusion but not anemia was associated with a protracted/prolonged post-operative stay. Transfusion and anemia were both associated with reduced survival however only anemia was associated with decreased survival in multi-variable modeling. Sixty-eight percent of patients were transfused post-operatively and 11% were compliant with the restrictive threshold of 7 g/dL.
conclusionsPre-operative anemia and transfusion are closely associated, however only anemia was found to compromise survival in our esophageal cancer cohort, supporting the need for more aggressive evaluation and treatment of anemia. Adherence to restrictive transfusion guidelines offers an opportunity to reduce transfusion rates which may also improve short-term outcomes.
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