title: Incidence of anemia in patients receiving neoadjuvant chemotherapy for locally advanced esophagogastric cancer.
abstract: BACKGROUND
  There is rising evidence that anemia and blood transfusion increase perioperative mortality in cancer patients. Patients who are treated with neoadjuvant chemotherapy with a curative intent are exposed to toxicity that may negatively affect their future outcome.
  
  
  METHODS
  The charts of 29 patients (21 males; median age, 59.5 years; range, 37 to 73), receiving neoadjuvant chemotherapy for cT3 esophagogastric adenocarcinoma operated at a single university center in the year 2002, were retrospectively reviewed to assess the incidence of anemia and blood transfusions.
  
  
  RESULTS
  Twenty-six patients received platinum-based chemotherapy over a period of 12 weeks and three patients more than 6 weeks. The median hemoglobin level (Hb level) before chemotherapy was 14.0 g/dL (range, 10.4 to 15.9 g/dL), the median decline of the Hb level was 2.9 g/dL (range, 0.3 to 6.3 g/dL); this drop was statistically significant (p < 0.001, 95% confidence interval). Patients who received preoperative blood transfusions (n = 8, 28%) had a significantly increased risk of developing postoperative complications (p = 0.028).
  
  
  CONCLUSIONS
  Preoperative chemotherapy for locally advanced esophagogastric cancer induces anemia and therefore leads to preoperative blood supplementation in a considerable number of patients. Data indicate that this may counteract the beneficial effects of neoadjuvant treatment.
authors.affiliation: Centre Hospitalier Universitaire Vaudois, Multidisciplinary Oncology Center, Lausanne, Switzerland. verena.voelter@hospvd.ch
authors.forename: Verena
authors.initials: V
authors.lastname: Voelter
authors.forename: Christoph
authors.initials: C
authors.lastname: Schuhmacher
authors.forename: Raymonde
authors.initials: R
authors.lastname: Busch
authors.forename: Christian
authors.initials: C
authors.lastname: Peschel
authors.forename: Jörg Rüdiger
authors.initials: JR
authors.lastname: Siewert
authors.forename: Florian
authors.initials: F
authors.lastname: Lordick
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D000328:Adult; D000368:Aged; D000740:Anemia / Q000139:chemically induced* / Q000453:epidemiology* / Q000628:therapy; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002945:Cisplatin / Q000008:administration & dosage / Q000009:adverse effects*; D018572:Disease-Free Survival; D017707:Erythrocyte Transfusion; D004938:Esophageal Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D004943:Esophagogastric Junction; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D015994:Incidence; D002955:Leucovorin / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy / Q000009:adverse effects*; D009367:Neoplasm Staging; D012189:Retrospective Studies
chemical_list: D002945:Cisplatin; D002955:Leucovorin; D005472:Fluorouracil