title: Decrease in hemoglobin levels following surgery influences the outcome in head and neck cancer patients treated with accelerated postoperative radiotherapy.
abstract: OBJECTIVE
  To assess the influence of hemoglobin (Hb) levels in locally advanced head and neck cancer (LAHNC) patients treated with surgery and postoperative radiotherapy (PORT).
  
  
  METHODS
  Pre- and postoperative Hb levels were collected in 79 patients treated with surgery followed by accelerated PORT for LAHNC. Median follow-up was 52 months (range 12-95 months).
  
  
  CONCLUSIONS
  Four-year overall survival (OS) rate was 51%. Neither pre- nor postoperative Hb level (<120 or 130 g/l in women or men, respectively) influenced the outcome. However, when Hb decrease between pre- and postoperative Hb values was taken into account, 4-year OS was significantly higher in patients with Hb difference less than 38 g/l (quartile value) compared with those with Hb decrease 38 g/l or more (61% versus 16%, P = 0.008).
  
  
  CONCLUSIONS
  Decrease in Hb level by more than 38 g/l after surgery secondary to blood loss influences the outcome when postoperative RT is indicated.
authors.affiliation: Radiation Oncology, University Hospital Center, University of Lausanne, Lausanne, Switzerland.
authors.forename: Berrin
authors.initials: B
authors.lastname: Pehlivan
authors.forename: Abderrahim
authors.initials: A
authors.lastname: Zouhair
authors.forename: François
authors.initials: F
authors.lastname: Luthi
authors.forename: Luc
authors.initials: L
authors.lastname: Bron
authors.forename: Philippe
authors.initials: P
authors.lastname: Pasche
authors.forename: Daniela
authors.initials: D
authors.lastname: Dragusanu
authors.forename: David
authors.initials: D
authors.lastname: Azria
authors.forename: Oscar
authors.initials: O
authors.lastname: Matzinger
authors.forename: René O
authors.initials: RO
authors.lastname: Mirimanoff
authors.forename: Mahmut
authors.initials: M
authors.lastname: Ozsahin
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016063:Blood Loss, Surgical / Q000401:mortality; D005260:Female; D006258:Head and Neck Neoplasms / Q000097:blood / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D006454:Hemoglobins / Q000032:analysis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D013517:Otorhinolaryngologic Surgical Procedures; D011182:Postoperative Care; D018714:Radiotherapy, Adjuvant / Q000401:mortality; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D006454:Hemoglobins