Anemia is the strongest prognostic factor for outcomes of 5-fluorouracil-based first-line chemotherapy in patients with advanced gastric cancer.
OBJECTIVE
To examine the prevalence of anemia and its impact of hemoglobin (Hgb) levels in predicting outcomes of 5-fluorouracil (FU)-based first-line chemotherapy for patients with advanced gastric cancer (AGC).


METHODS
We collected data retrospectively from 511 consecutive patients treated with FU-based first-line chemotherapy as a routine clinical practice for AGC and followed up in two centers from 1995 to 2003. FU was given in combination with cisplatin (61%), taxanes (12%), anthracyclines (24%) and/or folinic acid (50%).


RESULTS
Hgb values were <10 g/dl in 41%, and patients with baseline Hgb levels <10 g/dl had significantly lower response rates (9%) than patients with Hgb > or = 10 g/dl (53%; P < 0.001). In addition, Hgb < 10 g/dl served as a predictor for disease progression (RR, 1.77; 95% CI, 1.42-2.21) and death (RR, 1.85; 95% CI, 1.48-2.32) along with chemotherapy response and performance status.


CONCLUSIONS
Low baseline Hgb level is a strong and independent prognostic factor for the outcomes of AGC patients receiving FU-based first-line chemotherapy. This results strongly suggest that Hgb level, along with performance status, may be considered as a stratification variable in subsequent studies of AGC.
Park
Se Hoon
SH
Division of Hematology and Oncology, Department of Internal Medicine, Gachon Medical School Gil Medical Center, Incheon, 405-760 Korea.
Lee
Jeeyun
J
Lee
Se Hoon
SH
Park
Joon Oh
JO
Kim
Kihyun
K
Kim
Won Seog
WS
Jung
Chul Won
CW
Park
Young Suk
YS
Kang
Won Ki
WK
Park
Keunchil
K
Kim
Seonwoo
S
Bang
Soo Mee
SM
Cho
Eun Kyung
EK
Shin
Dong Bok
DB
Lee
Jae Hoon
JH
D000230:Adenocarcinoma / Q000097:blood / Q000150:complications / Q000188:drug therapy* / Q000401:mortality; D000328:Adult; D000368:Aged; D000740:Anemia / Q000097:blood / Q000150:complications*; D018572:Disease-Free Survival; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage / Q000627:therapeutic use*; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009362:Neoplasm Metastasis; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000097:blood / Q000150:complications / Q000188:drug therapy* / Q000401:mortality
D006454:Hemoglobins; D005472:Fluorouracil