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We analyzed the influence of packed red blood cell (PRBC) transfusions on the prognosis of 163 patients with gastric adenocarcinoma undergoing subtotal gastrectomy with a curative intention. Over a period of 15 years, our department admitted 505 patients with gastric adenocarcinoma, with curative subtotal gastrectomy being performed in 167 cases. Mean age was 62.2 years (range: 30-87); there was a predominance of males (104 cases; 63.8%). Excluding the four patients who died in the immediate postoperative period (first 30 days), the remaining 163 were reviewed twice yearly in our department until either they died or the study ended. Follow-up averaged 49.5 months, with a median of 36 months. Sixty-nine (42.3%) of the 163 patients received transfusions of PRBC. On correlating the variables with the transfusion, we found a statistical significance only between the rate of transfusion and patient age over 63 years (P0.01), with an evolution time of less than three months (P0.05) and in tumors of4 cm (P0.05). The five-year survival rate of the nontransfusion patients was 56.9% and of the transfusion patients 40%, with statistically significant differences (P = 0.0132). On studying patients according to tumor stage, we found that blood transfusion had a statistically significant influence on prognosis only in patients with tumor stage III (P = 0.0051). In the univariate analysis of the remaining variables collected, the existence of abdominal tumor (P = 0.0307), tumor size (P = 0.00001), degree of involvement of the gastric wall (P = 0.00001), lymph node involvement (P = 0.00001) and tumor stage (P = 0.00001) revealed a statistically significant influence on prognosis. If we apply Cox's regression model to the variables that in the univariate analysis had a statistically significant influence on prognosis, we found that only tumor size and stage were independent predictors of survival. In our experience, PRBC transfusion does not influence the long-term survival of patients with resected gastric adenocarcinoma.

We present a series of 209 patients with cancer of the esophagus over a 13-year period. Average age was 61.99 years and 87.56% of the patients were male. As for histological type, 59.8% of cases were epidermoid carcinomas and the remaining adenocarcinomas. In 76.55% of cases tumor stage was III or IV. Operability rate was 81.8% and resectability 57.89%. The most frequent resective procedure was oesophagogastrectomy through a right thoracotomy and laparotomy. Reconstruction of digestive continuity was achieved in 86.77% with the stomach; 53.72 of resections were judged to be "radical". Overall postoperative morbidity was 45.61%. Respiratory failure and anastomotic leakage accounted for most of morbidity. Anastomotic leakage was more frequent in patients undergoing bypass, with cervical anastomosis, and when the reconstruction was performed with the colon. Mortality rate was 14.04%, but fell to 7.69% in patients undergoing "radical" resection. Overall 5-year survival was 7.83% and 11.81% in patients undergoing resection. The more relevant prognostic factor was tumour stage; 5-years survival of patients with tumor stage I-II was 27.53%, and 0% for patients with tumour stage II or IV.

The results of 313 gastric adenocarcinomas, treated by the same surgical team during 10 years have been evaluated retrospectively. The pathological characteristics, operability (88.8%) and resectability (69.8%) rates, surgical technique and morbility and mortality rates are analyzed. The causes of late mortality, total five-year survival, depending on the stage of the tumors, and survival in relation to treatment are reported.

A series is presented of 152 patients diagnosed over a 9-year period by endoscopy and biopsy as Barrett's esophagus. We analyzed epidemiological data and the risk of malignancy, and calculated the prevalence and incidence in our series.