title: Pre-operative anaemia in colon cancer patients became normal after more than a year post-operatively but did not influence oncological outcome in the final analysis.
abstract: BACKGROUND
  Pre-operative anaemia has been related to adverse outcomes after surgical management of colorectal cancer. How various factors may contribute to anaemia and also its post-operative recovery has not been extensively investigated.
  
  
  METHODS
  Two hundred and thirty five colon cancer patients treated surgically in a community teaching hospital in Norway between 2007 and 2009 were prospectively examined.
  
  
  RESULTS
  Anaemia was detected in 53.8%, which was dependent on tumour location, albumin level and female gender. More than 60% of all patients were overweight or obese. Pre-operative BMI was negatively associated with age and positively associated with albumin level (p = 0.018 for both). Haemoglobin levels slowly returned to normal during the first year in significant incremental steps, coincidental with an increase in BMI. At 6 months post-operative, age, albumin, female gender and TNM stage (p = 0.010; p = 0.020; p < 0.001; p = 0.028, respectively) were significantly connected with anaemia, whereas only age and albumin (p = 0.016; p = 0.004, respectively) were associated with a reduced BMI. Pre-operative anaemia gave a significantly worse overall survival (p = 0.040) in the univariate analysis but was not significant in the multivariate analysis.
  
  
  CONCLUSIONS
  Beside the influence of tumour location, it appeared that pre-operative Hgb had some relation to a reduced nutritional state. The post-operative recovery of anaemia was more closely related to an improved nutritional state. The relation between anaemia and oncological outcome should undergo further studies.
authors.affiliation: Department of Clinical Medicine, University of Norway, Bergen, Norway.
authors.forename: Ingrid
authors.initials: I
authors.lastname: Fjørtoft
authors.forename: Bjørg
authors.initials: B
authors.lastname: Furnes
authors.forename: Trygve
authors.initials: T
authors.lastname: Hausken
authors.forename: Kristian E
authors.initials: KE
authors.lastname: Storli
authors.forename: Geir Egil
authors.initials: GE
authors.lastname: Eide
authors.forename: Karl
authors.initials: K
authors.lastname: Søndenaa
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D018798:Anemia, Iron-Deficiency / Q000097:blood* / Q000209:etiology*; D015992:Body Mass Index; D003110:Colonic Neoplasms / Q000150:complications / Q000473:pathology* / Q000601:surgery*; D005260:Female; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009664:Norway; D011184:Postoperative Period; D057234:Preoperative Period; D011446:Prospective Studies; D012709:Serum Albumin / Q000378:metabolism; D012737:Sex Factors
chemical_list: D006454:Hemoglobins; D012709:Serum Albumin