Association between red blood cell transfusion and long-term mortality in patients with cancer of the esophagus after esophagectomy

: The impact of red blood cell transfusion on long-term mortality has not been well characterized in patients with cancer of the esophagus after esophagectomy. Our retrospective observational study investigated 611 patients with cancer of the esophagus after esophagectomy from January 2005 to December 2012. Perioperative red blood cell transfusion was defined as red blood cell transfusion during intraoperative and postoperative period. One hundred ninety-six (32.1%) patients received red blood cell transfusion. During follow-up period, 153 (36.9%) patients without red blood cell transfusion and 120 (61.2%) patients with red blood cell transfusion died. Multivariable analysis identified that there was an incremental association between the amount of red blood cell transfusion and long-term mortality (hazard ratio 1.06, 95% confidence interval 1.04-1.08, P < 0.001). The association between red blood cell transfusion and worse long-term mortality was also demonstrated in propensity-matched patients (hazard ratio 1.62, 95% confidence interval 1.15-2.28, P = 0.006). Therefore, there might be an independent association between perioperative red blood cell transfusion and worse long-term mortality in patients with cancer of the esophagus after esophagectomy. Furthermore, there was an incremental increase in long-term mortality in patients who was transfused with red blood cell during perioperative period.