Lee SD, Park JW, Park KS, Lim SB, Chang HJ, Kim DY, Jeong SY, Choi HS, Oh JH. Influence of anemia on tumor response to preoperative chemoradiotherapy for locally advanced rectal cancer.
Int J Colorectal Dis 2009;
24:1451-8. [PMID:
19582465 DOI:
10.1007/s00384-009-0762-7]
[Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/23/2009] [Indexed: 02/07/2023]
Abstract
PURPOSE
In rectal cancer patients treated with preoperative chemoradiotherapy (CRT) and curative resection, we evaluated the influence of anemia on tumor response to preoperative CRT.
METHODS
Between August 2001 and July 2007, 490 patients underwent preoperative CRT, followed by curative-intent surgery. Tumor responses were evaluated based on tumor regression grade (TRG), T- and N-level downstaging, and volume reduction rates.
RESULTS
The level of pretreatment hemoglobin (Hb) was 12.9 +/- 1.7 g/dl (range, 7.2-17.6 g/dl). Tumor response rates were significantly different below and above the Hb level of 9.0 g/dl. Specifically, patients with Hb levels >or=9.0 g/dl achieved better tumor responses than those with Hb levels < 9.0 g/dl (rates of TRG 3 or 4-29.0% vs. 0%, p < 0.001). In addition, there is no differences in tumor response between the nontransfusion and transfusion groups of patients with Hb levels >or=9.0 g/dl (rates of TRG 3 or 4-29.1% vs. 23.1%, p = 0.445).
CONCLUSIONS
The serum Hb level could be a one of prognostic factors that influences the pathologic tumor response, and pretreatment anemia (below 9.0 g/dl of Hb) is associated with poor response to preoperative CRT.
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