AB88. Impact of intraoperative blood loss on survival for gastric cancer after curative resection

Objectives: The study was aimed to evaluate the impact of intraoperative blood loss (IBL) on survival for gastric cancer after curative resection.

Methods: This study included 935 patients staged I-III who underwent curative gastrectomy for gastric cancer between 2003 and 2011. Patients were divided into 3 groups according to the amount of IBL: group1 (IBL less than 200 mL), group2 (IBL 200 to 400 mL) and group3 (IBL more than 400 mL). Survival curves were compared between the groups, and multivariate analysis was conducted to identify independent prognostic factors and risk factors for IBL no less than 200 mL.

Results: IBL was found to be an independent prognostic factor. The 5-year survival rates were 50.1, 38.2 and 21.9 for IBL less than 200, 200 to 400, and more than 400 mL, respectively (vs. 200-400 mL, Pvs. >400, P=0.001). Tumor location plus types of gastrectomy and combined organ resection were independently associated with IBL no less than 200 mL. By stratified analysis, for patients accepted subtotal gasrectomy or D2 resection or staged TNM I-II, these of IBL less than 200 mL tended to have a better survival than these IBL no less than 200 mL. While for patients accepted total gastrectomy or D1 resection or staged TNM III, those whose IBL was no more than 400 mL had a better survival.

Conclusions: IBL is an independent prognostic factor for gastric cancer after curative resection. Meticulous surgery is needed to decrease the amount of IBL and to improve the long-term outcome of patients following curative gastrectomy.

Keywords: Gastric cancer; intraoperative blood loss (IBL); survival rate; gastrectomy