The prognostic value of hemoglobin concentration in postoperative radiotherapy of 835 patients with laryngeal cancer.
OBJECTIVE
To investigate the prognostic value of hemoglobin (Hb) concentration in patients with laryngeal cancer treated with postoperative radiotherapy (pRT).


METHODS
The records of 835 patients who underwent pRT between 1980 and 2003 were reviewed. Most patients (526 of 835 patients; 63%) were in advanced clinical stages (T3-T4) and 371 of 835 patients (44%) were node positive. Total laryngectomy had been performed in 676 of 835 patients (81%). Median Hb concentration before (Hb0) and after pRT (Hb1) was the same (13.3 g/dl). However, individual differences between Hb1 and Hb0 (dHb) varied within a broad range (-8.8; 5.0 g/dl). Univariate and multivariate analyses were performed to identify variables significantly associated with locoregional control (LRC), metastases-free survival, and overall survival.


RESULTS
Patients with dHb greater than 0 had significantly improved 5-year LRC compared with those with dHb of 0 or less (80% vs. 72%, p = 0.01). Conversely, when categorized, neither Hb0 nor Hb1 had a significant influence on LRC. In multivariate analysis, dHb remained a prognostic factor for LRC (p = 0.01) among the other variables, which included overall radiation treatment time and nodal status. None of the Hb-related variables significantly influenced metastases-free or overall survival.


CONCLUSIONS
Individual change in Hb concentration during the course of pRT (dHb) rather than Hb level before or after pRT appeared as an independent prognostic factor for LRC in this set of patients.
Rutkowski
Tomasz
T
Radiotherapy Clinic, Center of Oncology, Maria Sklodowska-Curie Memorial Institute, Gliwice, Poland. tomr22@tlen.pl
Suwinski
Rafal
R
Idasiak
Adam
A
D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D000740:Anemia / Q000097:blood* / Q000401:mortality; D002294:Carcinoma, Squamous Cell / Q000097:blood* / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D006441:Hemoglobin A / Q000032:analysis*; D006801:Humans; D007822:Laryngeal Neoplasms / Q000097:blood* / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery; D007825:Laryngectomy; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate
D006441:Hemoglobin A