Prevalence and significance of anaemia in patients receiving long-course neoadjuvant chemoradiotherapy for rectal carcinoma
ABSTRACT Aim: The study aimed to assess the prevalence and significance of anaemia during long-course neo-adjuvant radiotherapy (LNRT) of rectal cancer at our centre. Method: Hospital coding and a prospective oncology database were used to identify all patients undergoing LNRT for rectal cancer at our centre between 2004-2009. A retrospective review of computerised records was used to extract individual patient data. Anaemia was defined as a haemoglobin (Hb) level <11.5 grammes/decilitre (g/dL) for men and <13 g/dl for women. Downstaging was assessed by comparing radiological (rTNM) to histological stage (ypTNM). Tumour regression after radiotherapy was assessed using the 'Rectal Cancer Regression Group (RCRG)' scores of 1-3. Results were analysed using GnuPSPP statistical software. Results: There were 70 patients (51 male) of median age of 66 (IQR 60-72.75) years. Of these 24 were anaemic. Two (3%) had no Hb recorded and were excluded. Forty-two percent of anaemic patients demonstrated mural (T) downstaging compared with 68% of non-anaemic patients (p=0.03). There was no differences in nodal downstaging between the groups. The RCRG scores showed more tumour regression in non-anaemic than anaemic patients as follows: RCRG 1 59% vs 30%, RCRG 2 11% vs 17%, RCRG 3 38% vs 46% (p< 0.001). Conclusion: The prevalence of anaemia in patients undergoing LNRT was 35%. Anaemia during LNRT was associated with significant reductions in tumour downstaging and regression. © 2012 The Authors Colorectal Disease © 2012 The Association of Coloproctology of Great Britain and Ireland.
- SourceAvailable from: Yufeng Cheng[Show abstract] [Hide abstract]
ABSTRACT: Few studies have investigated the relationship between anemia, smoking, drinking and survival in esophageal squamous cell carcinoma (ESCC) with primary radiotherapy. This study had the aim of evaluating the prognostic value of anemia, smoking and drinking in patients receiving primary radiotherapy for ESCC. A total of 79 patients who underwent radiotherapy during initial treatment for ESCC were included in this study. The 2-year overall survival (OS) and disease-free survival (DFS) were analyzed between the anemic and non-anemic groups, non-smokers and smokers, and non-drinkers and drinkers using the Kaplan-Meier method and the Cox proportional hazards model. There were 79 patients (10 male) of median age 63 (range 38 to 84) years. The 2-year OS and DFS were 36% and 25%, respectively, in the non-anemic group, and 17% and 13%, respectively, in the anemic group (P = 0.019 for OS; P = 0.029 for DFS) using the Kaplan-Meier method. Survival analysis using the Kaplan-Meier method showed that the 2-year OS and DFS had no statistical difference between smoking, drinking and survival. In a univariate analysis, anemia was identified as a significant prognostic factor for 2-year OS (hazard ratio (HR) = 1.897; P = 0.024) and 2-year DFS (HR = 1.776; P = 0.036), independent of tumor, lymph node, metastasis (TNM) stage. In a multivariate analysis, anemia was identified as a highly significant prognostic factor for 2-year OS (HR = 2.125; P = 0.011) and 2-year DFS (HR = 1.898; P = 0.025), independent of TNM stage and initial treatment. We found no statistical difference in the 2-year OS and DFS associated with smoking (P > 0.2) and drinking (P > 0.6) using univariate and multivariate analysis. Smoking and drinking were not prognostic for 2-year OS or DFS. Anemia before radiotherapy was associated with poor prognosis and an increased risk of relapse, which may serve as a new prognostic characteristic in ESCC treated with primary radiotherapy. Hemoglobin is a routine examination and anemia is therefore simple and quick to determine.World Journal of Surgical Oncology 10/2013; 11(1):249. DOI:10.1186/1477-7819-11-249 · 1.20 Impact Factor
- Colorectal Disease 10/2013; 15(10):1199-200. DOI:10.1111/codi.12429 · 2.02 Impact Factor
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ABSTRACT: BackgroundThe relationship between anemia and outcomes after radiotherapy has not been systematically addressed. The study aimed to assess the prevalence and prognostic value of anemia in patients receiving primary radiotherapy for esophageal squamous cell carcinoma (ESCC).MethodsA total of 103 patients with ESCC were retrospectively reviewed. Anemia was defined as a hemoglobin level <12 g/dl for men and <11 g/dl for women. The 3-year and 5-year overall survival (OS) and disease-free survival (DFS) were analyzed between the anemic and non-anemic groups using the Kaplan-Meier method and the Cox proportional hazards model.ResultsNo significant differences were observed in patient characteristics between the anemic and non-anemic groups. The prevalence of anemia was 29.1%. The 3-year and the 5-year OS were 43% and 37%, respectively, in the non-anemic group, and 20% and 17%, respectively, in the anemic group. The 3-year and the 5-year DFS were 37% and 26%, respectively, in the non-anemic group, and 13% and 10%, respectively, in the anemic group. Survival analysis using the Kaplan-Meier method showed that there was significant difference between anemia and non-anemia (P < 0.02). In a multivariate analysis, anemia was identified as a highly significant prognostic factor for 3-year OS (hazard ratio 1.916; P = 0.012) and 3-year DFS (hazard ratio 1.973; P = 0.007), independent of T stage and the status of lymph nodes, and 5-year OS (hazard ratio 1.705; P = 0.027) and 5-year DFS (hazard ratio 1.980; P = 0.005), independent of TNM stage and the status of lymph nodes.ConclusionsAnemia before primary radiotherapy was associated with poor prognosis and an increased risk of relapse, which may serve as a new prognostic factor for ESCC.World Journal of Surgical Oncology 08/2014; 12(1):244. DOI:10.1186/1477-7819-12-244 · 1.20 Impact Factor