Influence of anemia on tumor response to preoperative chemoradiotherapy for locally advanced rectal cancer.
OBJECTIVE
In rectal cancer patients treated with preoperative chemoradiotherapy (CRT) and curative resection, we evaluated the influence of anemia on tumor response to preoperative CRT.


METHODS
Between August 2001 and July 2007, 490 patients underwent preoperative CRT, followed by curative-intent surgery. Tumor responses were evaluated based on tumor regression grade (TRG), T- and N-level downstaging, and volume reduction rates.


RESULTS
The level of pretreatment hemoglobin (Hb) was 12.9 +/- 1.7 g/dl (range, 7.2-17.6 g/dl). Tumor response rates were significantly different below and above the Hb level of 9.0 g/dl. Specifically, patients with Hb levels >or=9.0 g/dl achieved better tumor responses than those with Hb levels < 9.0 g/dl (rates of TRG 3 or 4-29.0% vs. 0%, p < 0.001). In addition, there is no differences in tumor response between the nontransfusion and transfusion groups of patients with Hb levels >or=9.0 g/dl (rates of TRG 3 or 4-29.1% vs. 23.1%, p = 0.445).


CONCLUSIONS
The serum Hb level could be a one of prognostic factors that influences the pathologic tumor response, and pretreatment anemia (below 9.0 g/dl of Hb) is associated with poor response to preoperative CRT.
Lee
Seong Dae
SD
Center for Colorectal Cancer, Research Institute & Hospital, National Cancer Center, Gyeonggi-do, South Korea.
Park
Ji Won
JW
Park
Kui Seon
KS
Lim
Seok-Byung
SB
Chang
Hee Jin
HJ
Kim
Dae Yong
DY
Jeong
Seung-Yong
SY
Choi
Hyo Seong
HS
Oh
Jae Hwan
JH
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000740:Anemia / Q000150:complications*; D001803:Blood Transfusion; D005260:Female; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D011300:Preoperative Care; D011379:Prognosis; D012004:Rectal Neoplasms / Q000150:complications / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy*; D012074:Remission Induction
D006454:Hemoglobins