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.