title: Anemia may influence the outcome of patients undergoing neo-adjuvant treatment of rectal cancer.
abstract: BACKGROUND
  We hypothesized that anemia could represent one of the major factors influencing the outcome of patients undergoing neo-adjuvant treatment of rectal cancer.
  
  
  METHODS
  This analysis included all the consecutive patients who underwent neo-adjuvant treatment (chemotherapy and/or radiotherapy) before surgery for rectal cancer in three oncology/radiotherapy departments from June 1996 to December 2003.
  
  
  RESULTS
  Three hundred and seventeen patients were eligible for our analysis. Median age at diagnosis was 64 years (range 26-88 years); male/female ratio was 184/133. Two hundred and eighty-five patients (89.9%) were diagnosed with adenocarcinoma, while 32/317 (10.1%) with mucinous adenocarcinoma. Neo-adjuvant treatments carried out were as follows: radiotherapy alone in 75/317 patients (23.7%), radiotherapy plus chemotherapy in 242/317 patients (76.3%). At univariate and multivariate analysis, only the hemoglobin (Hb) level (group 1: < or=12 g/dl versus group 2: >12 g/dl) resulted in a significant factor for disease-free survival. The role of the Hb level seemed to be confirmed further by the clinical downstaging obtained in approximately 55% of patients in group 2, in comparison with 35% of the patients achieving a significant downstaging in group 1.
  
  
  CONCLUSIONS
  Our results indicated that anemia could represent an important parameter able to influence the outcome in patients receiving neo-adjuvant treatment of rectal cancer.
authors.affiliation: Department of Oncology and Radiotherapy, Azienda Ospedaliero-Universitaria Ospedali Riuniti Umberto I-GM Lancisi-G Salesi di Ancona, Italy. r.berardi@univpm.it
authors.forename: R
authors.initials: R
authors.lastname: Berardi
authors.forename: C
authors.initials: C
authors.lastname: Braconi
authors.forename: G
authors.initials: G
authors.lastname: Mantello
authors.forename: M
authors.initials: M
authors.lastname: Scartozzi
authors.forename: S
authors.initials: S
authors.lastname: Del Prete
authors.forename: G
authors.initials: G
authors.lastname: Luppi
authors.forename: R
authors.initials: R
authors.lastname: Martinelli
authors.forename: M
authors.initials: M
authors.lastname: Fumagalli
authors.forename: G
authors.initials: G
authors.lastname: Valeri
authors.forename: I
authors.initials: I
authors.lastname: Bearzi
authors.forename: C
authors.initials: C
authors.lastname: Marmovale
authors.forename: F
authors.initials: F
authors.lastname: Grillö-Ruggieri
authors.forename: S
authors.initials: S
authors.lastname: Cascinu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000740:Anemia / Q000150:complications*; D016001:Confidence Intervals; D018572:Disease-Free Survival; D005260:Female; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D020360:Neoadjuvant Therapy; D016016:Proportional Hazards Models; D012004:Rectal Neoplasms / Q000150:complications* / Q000628:therapy*; D016896:Treatment Outcome
chemical_list: D006454:Hemoglobins