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The authors discuss evidence indicating that transfused patients can show lower overall and disease-free survival, with multivariate models supporting transfusion as an independent risk factor. It further highlights elevated postoperative inflammatory markers and argues that causality interpretation requires adjusted analyses. Future research directions include extended temporal characterization, functional immunological assessment, prospective designs with detailed transfusion data, machine learning, and mechanistic studies across biological and temporal levels.",{"@graph":69,"@context":126},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/influence-of-blood-transfusion-on-outcomes-in-patients-with-gastric-cancer/362585/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/influence-of-blood-transfusion-on-outcomes-in-patients-with-gastric-cancer/362585.png","ImageObject",300,407,{"name":92,"@type":93},"Alex Sinclair","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-03","2026-09-23",true,{"@type":102,"interactionType":103,"userInteractionCount":52},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118,122],{"name":109,"@type":110,"acceptedAnswer":111},"What main relationship does the letter focus on in gastric cancer patients?","Question",{"text":112,"@type":113},"The letter focuses on how perioperative blood transfusion relates to inflammatory responses and long-term clinical outcomes in gastric cancer.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"What evidence is discussed regarding survival outcomes after transfusion?",{"text":117,"@type":113},"It describes findings that transfused patients may have significantly worse overall survival and disease-free survival, and it notes multivariate Cox regression supporting transfusion as an independent predictor.",{"name":119,"@type":110,"acceptedAnswer":120},"Which biomarkers and analytic methods are highlighted as part of the evidence base?",{"text":121,"@type":113},"The letter highlights postoperative inflammatory markers such as IL-6, TNF-α, and CRP, and discusses the need to interpret causality in light of studies using adjusted analyses.",{"name":123,"@type":110,"acceptedAnswer":124},"What future research approaches does the abstract recommend?",{"text":125,"@type":113},"It recommends extended temporal characterization, functional immunological assessment, prospective designs with detailed transfusion data, machine learning methods, and mechanistic studies.","https://schema.org",{"og:url":83,"og:type":128,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":130,"canonical":83},"index,follow",{"doc_id":132,"site_id":62},362585,1790441204,{"code":4,"msg":5,"data":135},{"doc_id":132,"user_id":136,"nickname":92,"user_avatar":137,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":138,"file_id":139,"file_url":140,"file_type":141,"file_size":142,"view_count":52,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":29,"language":143,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":144,"faqs":145,"seo_title":146,"seo_description":67,"update_tm":147,"read_time":148},1099523882182,"https://ap-avatar.wpscdn.com/davatar_6f874abed73319feea01a86fa6f0fab8","| W | J | G | World Journal of\u003Cbr>Gastroenterology |\n| --- | --- | --- | --- |\n\nSubmit a Manuscript: [https://www.f6publishing.com](https://www.f6publishing.com) World J Gastroenterol 2026 March 14; 32(10): 115683  \nDOI: 10.3748/wjg.v32.i10.115683 ISSN 1007-9327 (print) ISSN 2219-2840 (online)  \nLETTER TO THE EDITOR  \nInfluence of blood transfusion on outcomes in patients with gastric cancer  \nPrateek Maurya, Anju Gupta, Nishkarsh Gupta  \nProvenance and peer review:  \nInvited article; Externally peer reviewed.  \nPeer-review model: Single blind  \nPeer-review report’s classification Scientific Quality: Grade B, Grade B  \nNovelty: Grade B, Grade B  \nCreativity or Innovation: Grade B, Grade B  \nScientific Significance: Grade B, Grade B  \nP-Reviewer: Bao YL, PhD, Professor, China; Li P, MD, PhD, Chief Physician, Post Doctoral Researcher, Professor, Senior  \nResearcher, China  \nReceived: October 22, 2025  \nRevised: December 9, 2025  \nAccepted: December 30, 2025  \nPublished online: March 14, 2026  \nProcessing time: 131 Days and 5.1 Hours  \n©Author(s) (or their employer(s))  \n2026. No commercial re-use. See Permissions. Published by Baishideng Publishing Group Inc.  \nPrateek Maurya, Nishkarsh Gupta, Department of Onco-Anaesthesia and Palliative Medicine, Dr.  \nB.R.A. Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi 110029, India  \nAnju Gupta, Department of Anesthesiology, Pain Medicine and Critical Care, All India Institute of Medical Sciences, New Delhi 110029, India  \nORCID number: Prateek Maurya 0009-0008-5047-7911; Anju Gupta 0000-0001-7264-7194; Nishkarsh Gupta 0000-0002-8444-2564.  \nCo-first authors: Prateek Maurya and Anju Gupta.  \nCorresponding author: Nishkarsh Gupta, Professor, Department of Onco-Anaesthesia and Palliative Medicine, Dr. B.R.A. Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, Room No. 139 FF IRCH, New Delhi 110029, [India.](India. drnishkarsh@rediffmail.com)[ drnishkarsh@rediffmail.com](India. drnishkarsh@rediffmail.com)  \nAbstract  \nChen et al's research provides valuable data supporting the cautious use of transfusions during gastric cancer surgery. However, to interpret causality, it must be acknowledged that recent tend-adjusted studies have consistently shown that the independent effect of transfusions may be smaller than that shown in unadjusted analyses. Future research should employ the following approaches: (1) Extended temporal characterization; (2) Functional immunological assessment; (3) Prospective designs incorporating detailed transfusion data; (4) Machine learning methods; and (5) Mechanistic studies. The relationship between transfusions and cancer treatment outcomes goes far beyond simple immunosuppression or inflammation. It reflects a complex interplay between patient vulnerability, surgical factors, and immune responses, requiring a comprehensive study across multiple biological levels and temporal dimensions.  \nKey Words: Blood; Cancer; Gastric; Immune response; Transfusion; Prognosis  \n [https://dx.doi.org/10.3748/wjg.v32.i10.115683](https://dx.doi.org/10.3748/wjg.v32.i10.115683) 1 March 14, 2026  Volume 32  Issue 10   \nMaurya P et al. Gastric cancer and blood transfusion  \nCore Tip: The relationship between blood transfusion and cancer outcomes extends far beyond simple immunosuppression or inflammation. It represents a complex interplay of evolutionary biology, immunology, and modern medicine that demands sophisticated investigation. Only through comprehensive approaches integrating multiple biological scales and temporal dimensions can we transform blood transfusion from a necessary evil to a precision therapeutic intervention in surgical oncology, ultimately improving outcomes for the thousands of gastric cancer patients who undergo surgery each year.  \nCitation: Maurya P, Gupta A, Gupta N. Influence of blood transfusion on outcomes in patients with gastric cancer. World JGastroenterol 2026; 32(10): 115683  \nURL: [https:/","cbCaia9WrARW5raL","https://ap.wps.com/l/cbCaia9WrARW5raL","pdf",404601,"English","# Letter to the Editor\n## Influence of blood transfusion on outcomes in patients with gastric cancer\n## Abstract and key terms\n## Contextualizing within gastric cancer-specific evidence\n## Clinical data and inflammatory markers","[{\"question\":\"What main relationship does the letter focus on in gastric cancer patients?\",\"answer\":\"The letter focuses on how perioperative blood transfusion relates to inflammatory responses and long-term clinical outcomes in gastric cancer.\"},{\"question\":\"What evidence is discussed regarding survival outcomes after transfusion?\",\"answer\":\"It describes findings that transfused patients may have significantly worse overall survival and disease-free survival, and it notes multivariate Cox regression supporting transfusion as an independent predictor.\"},{\"question\":\"Which biomarkers and analytic methods are highlighted as part of the evidence base?\",\"answer\":\"The letter highlights postoperative inflammatory markers such as IL-6, TNF-α, and CRP, and discusses the need to interpret causality in light of studies using adjusted analyses.\"},{\"question\":\"What future research approaches does the abstract recommend?\",\"answer\":\"It recommends extended temporal characterization, functional immunological assessment, prospective designs with detailed transfusion data, machine learning methods, and mechanistic studies.\"}]","Influence of blood transfusion on outcomes in patients with gastric cancer | PDF",1790148444,15]