title: Iron-deficiency anemia: a predictor of diminished disease-free survival of T3N0M0 stage colon cancer.
abstract: OBJECTIVE
  The aim of this study was to determine whether iron-deficiency anemia (IDA) predicts long-term oncologic outcomes in patients with TNM stage II colon cancer.
  
  
  METHODS
  Clinical and follow-up data were extracted from a prospective colon cancer database. Univariate and multivariate analyses were performed to identify IDA and other predictors of long-term oncologic outcomes.
  
  
  RESULTS
  Among 644 patients, 147 (22.8%) patients presented with IDA. The data were stratified by T3N0M0 and T4N0M0. The distribution difference of IDA between the two subsets was not significant (P = 0.340). But in the T4N0M0 subset, the incidence of IDA increased with the depth of tumor penetration (75.9% and 18.2% for the patients with and without adjacent organ involvement, respectively, P = 0.011). IDA predicted a worse disease-free survival among patients with T3N0M0 cancer (472 patients; log-rank test, P = 0.016; Cox regression, P = 0.009), but it was not a predictor in T4N0M0 cancer patients (172 patients; log-rank test, P = 0.016; Cox regression, P > 0.05).
  
  
  CONCLUSIONS
  IDA was an independent predictor of long-term outcome in T3N0M0 stage, but not in T4N0M0 colon cancer. T3N0M0 stage colon cancer patients with IDA could be included in future trials of adjuvant therapies.
authors.affiliation: Department of General Surgery, Fourth Affiliated Hospital of China Medical University, Shenyang, China.
authors.forename: Li
authors.initials: L
authors.lastname: Zhen
authors.forename: Sun
authors.initials: S
authors.lastname: Zhe
authors.forename: Wang
authors.initials: W
authors.lastname: Zhenning
authors.forename: Miao
authors.initials: M
authors.lastname: Zhifeng
authors.forename: Lv
authors.initials: L
authors.lastname: Zhidong
authors.forename: Li
authors.initials: L
authors.lastname: Xiaoxia
authors.forename: Yang
authors.initials: Y
authors.lastname: Jianguang
authors.forename: Xu
authors.initials: X
authors.lastname: Huimian
mesh_terms: D000230:Adenocarcinoma / Q000150:complications / Q000401:mortality / Q000601:surgery; D002288:Adenocarcinoma, Mucinous / Q000150:complications / Q000401:mortality / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018798:Anemia, Iron-Deficiency / Q000175:diagnosis* / Q000209:etiology*; D018279:Carcinoma, Signet Ring Cell / Q000150:complications / Q000401:mortality / Q000601:surgery; D003110:Colonic Neoplasms / Q000150:complications* / Q000401:mortality* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000401:mortality; D009367:Neoplasm Staging; D011379:Prognosis; D011446:Prospective Studies; D015996:Survival Rate; D055815:Young Adult