Pretreatment anemia is associated with poorer survival in patients with stage I and II gastric cancer.
OBJECTIVE
A negative correlation between anemia and outcome has been demonstrated in various cancers treated with radiotherapy. However, it is rarely studied whether this correlation may exist in surgical setting. Our aim was to investigate the relationship between pretreatment anemia and survival in surgically treated patients with gastric cancer.


METHODS
A total of 1,688 patients who had undergone curative resection for gastric cancer between 1991 and 1995 were reviewed. Anemia was defined as a hemoglobin level <12.0 g/dl. The influence of anemia on patient overall survival was evaluated by univariate and multivariate analysis.


RESULTS
Pretreatment anemia was present in 39.9% of the patients. The 10-year overall survival rate in anemic patients was 48.2% as compared with 62.6% in nonanemic patients (P < 0.001). In subgroup analysis according to the stage, the significant difference in 10-year overall survival rate between anemic and nonanemic patients was found in stage I and II gastric cancer (76.1% vs. 83.5% in stage I, P = 0.030; 55.1% vs. 67.2% in stage II, P = 0.043). On multivariate analysis, anemia was an independent prognostic predictor in patients with stage I and II disease (P = 0.007; RR, 1.466; 95% CI, 1.109-1.937).


CONCLUSIONS
Pretreatment anemia was found to have an independent relationship to the long-term survival of patients with stage I and II gastric cancer.
Shen
Jian Guo
JG
Department of Surgery, Yonsei University College of Medicine, Seoul, Korea.
Cheong
Jae Ho
JH
Hyung
Woo Jin
WJ
Kim
Junuk
J
Choi
Seung Ho
SH
Noh
Sung Hoon
SH
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000740:Anemia / Q000150:complications / Q000628:therapy*; D001803:Blood Transfusion; D015331:Cohort Studies; D005260:Female; D005743:Gastrectomy / Q000401:mortality; D006801:Humans; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D009752:Nutritional Status; D011379:Prognosis; D012189:Retrospective Studies; D013156:Splenectomy; D013274:Stomach Neoplasms / Q000150:complications / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D015996:Survival Rate