PURPOSE: Local hypoxia has been linked to a higher risk of metastasis in patients with cancer of the uterine cervix and a haemoglobin concentration of 7.45 mmol/l or less. It is unknown whether the same holds true for rectal cancer. We evaluated the independent impact of pre-operative anaemia on survival in patients with rectal cancer. PATIENTS AND METHODS: A random set of 144 patients diagnosed with Dukes' A, B or C rectal cancer in the period 1995-1999 and registered in the database of the Eindhoven Cancer Registry was included in a survival analysis. Parameters tested were gender, age, pre-operative haemoglobin concentration, tumour stage and therapy. The ones that showed a relation with survival (log-rank test, p<0.1) were entered in a multivariate analysis. RESULTS: For patients without pre-operative anaemia, the hazard ratio of death was 0.35 (95% confidence interval 0.19-0.65, p=0.001), which indicates a three times higher mortality risk. For patients with a higher tumour stage (Dukes' B vs. Dukes' A or Dukes' C vs. Dukes' B) the hazard ratio of death was 1.52 (95% CI 1.04-2.23, p=0.03). For older patients (64-73 years vs. <64 years or >73 years vs. 64-73 years) the hazard ratio of death was 1.85 (95% CI 1.29-2.63, p=0.001). CONCLUSION: Long-term survival was significantly affected in rectal cancer patients with pre-operative anaemia. Further study on the relation between anaemia, tumour oxygenation and prognosis is needed, as it may have implications for future therapy.
PURPOSE: Local hypoxia has been linked to a higher risk of metastasis in patients with cancer of the uterine cervix and a haemoglobin concentration of 7.45 mmol/l or less. It is unknown whether the same holds true for rectal cancer. We evaluated the independent impact of pre-operative anaemia on survival in patients with rectal cancer. PATIENTS AND METHODS: A random set of 144 patients diagnosed with Dukes' A, B or C rectal cancer in the period 1995-1999 and registered in the database of the Eindhoven Cancer Registry was included in a survival analysis. Parameters tested were gender, age, pre-operative haemoglobin concentration, tumour stage and therapy. The ones that showed a relation with survival (log-rank test, p<0.1) were entered in a multivariate analysis. RESULTS: For patients without pre-operative anaemia, the hazard ratio of death was 0.35 (95% confidence interval 0.19-0.65, p=0.001), which indicates a three times higher mortality risk. For patients with a higher tumour stage (Dukes' B vs. Dukes' A or Dukes' C vs. Dukes' B) the hazard ratio of death was 1.52 (95% CI 1.04-2.23, p=0.03). For older patients (64-73 years vs. <64 years or >73 years vs. 64-73 years) the hazard ratio of death was 1.85 (95% CI 1.29-2.63, p=0.001). CONCLUSION: Long-term survival was significantly affected in rectal cancerpatients with pre-operative anaemia. Further study on the relation between anaemia, tumour oxygenation and prognosis is needed, as it may have implications for future therapy.
Authors: Valery E P P Lemmens; Maryska L G Janssen-Heijnen; Saskia Houterman; Kees D G W Verheij; Hendrik Martijn; Lonneke van de Poll-Franse; Jan Willem W Coebergh Journal: World J Surg Date: 2007-01 Impact factor: 3.352
Authors: W Ceelen; T Boterberg; P Smeets; N Van Damme; P Demetter; O Zwaenepoel; L Cesteleyn; P Houtmeyers; M Peeters; P Pattyn Journal: Br J Cancer Date: 2007-02-13 Impact factor: 7.640
Authors: Juha P Väyrynen; Anne Tuomisto; Sara A Väyrynen; Kai Klintrup; Toni Karhu; Jyrki Mäkelä; Karl-Heinz Herzig; Tuomo J Karttunen; Markus J Mäkinen Journal: Sci Rep Date: 2018-01-18 Impact factor: 4.379
Authors: Rebecca C Dru; Nathan J Curtis; Emma L Court; Catherine Spencer; Sara El Falaha; Godwin Dennison; Richard Dalton; Andrew Allison; Jonathan Ockrim; Nader K Francis Journal: Int J Colorectal Dis Date: 2020-06-02 Impact factor: 2.571