Influence of hemoglobin levels on survival after radical treatment of esophageal carcinoma with radiotherapy

Julve, J. Valencia; Orduña, Vicente Alonso; Barón, R. Esco; López-Mata, M.; Villamón, A. Méndez

doi:10.1007/s12094-006-0091-z

Cited by 14 publications

(11 citation statements)

References 19 publications

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“…We found that symptoms, performance status, and use of analgesics seemed to better prognosticate survival than the tumor characteristics. The reduced performance status and higher level of weight loss at admission in the ‘short’ survivors, compared to the ‘long’ survivors, is similar to data reported in other studies 2–4 . The associations found between levels of pain and swallowing difficulties on the one hand and survival on the other are not commonly reported.…”

Section: Discussionsupporting

confidence: 87%

Section: Introductionmentioning

confidence: 99%

“…It is important to choose a treatment modality that rapidly relieves the dysphagia, preferably with a short hospital stay. In addition, the duration of the response should be adequately relative to the patients' life expectancy which has been reported to be related to clinical prognostic factors such as performance status, weigh loss, tumor length, clinical stage, [2][3][4] but also to sex and age. 5 In order to describe the palliative care and prognosis of advanced esophageal cancer patients, the clinical characteristics of patients in relation to survival and the treatment modalities applied were explored in a retrospective study of all patients treated at the Norwegian Radium Hospital (NRH) in the 10-year period from 1990 to 1999.…”

Section: Introductionmentioning

confidence: 99%

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Palliative interventions and prognosis in patients with advanced esophageal cancer

Amdal

Jacobsen

Tausjø

et al. 2011

Diseases of the Esophagus

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In a retrospective review, in order to describe the palliative care and prognosis of patients with advanced cancer of the esophagus, the clinical characteristics and the treatment modalities applied were explored in relation to survival and symptom relief for 261 patients treated without curative potential. The data were obtained from a study of all patients with cancer of the esophagus treated at the Norwegian Radium Hospital in the 10-year period from 1990 to 1999. Medical data of the patients were reviewed and missing clinical information was retrieved from local hospitals and general practitioners. The patients were divided into three groups based upon the overall survival from start of treatment to death. Survival ≤3 months is in this paper, defined as 'short,' while survival > 6 months is defined as 'long.' Median survival for the total group of patients was 4 months. The 1-, 2-, and 3-year survival was 8%, 3%, and 1%, respectively. Patients with short survival (n= 107) had more advanced disease, lower performance status, and more dysphagia, weight loss, and pain and used more analgesics than patients with long survival (n= 91). Tumor characteristics such as localization, tumor length, and histology were not significantly associated with survival. This result was confirmed in a logistic regression analysis (with backward stepwise elimination) including sex, age, clinical stage, tumor length, tumor localization, histology, performance status, dysphagia, weight loss, and pain, where clinical stage, performance status, weight loss, and pain were included in the final model. A large variety of first-line palliative treatments were applied within the studied time period; external radiotherapy ± brachytherapy (n= 149), brachytherapy alone (n= 44), endoluminal stent (n= 28), laser evaporization (n= 8), chemotherapy (n= 5), and best supportive care only (n= 27). There were no clear differences in the effect on dysphagia between the modalities. Fourteen percent of the patients had treatment related complications. In conclusion, symptoms, performance status, and use of analgesics seemed to better prognosticate survival than tumor characteristics other than stage of disease. Our study reveals that knowledge about prognostic factors is crucial for the choice of palliative treatment. Even though all of the different treatment modalities seemed to provide relief of dysphagia, several other factors should be considered when deciding which treatment modality to offer. The time to onset of relief, duration of response, level of complications, and time spent in hospital should be a part of the decision-making process when selecting the appropriate treatment.

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Section: Discussionsupporting

confidence: 87%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Palliative interventions and prognosis in patients with advanced esophageal cancer

Amdal

Jacobsen

Tausjø

et al. 2011

Diseases of the Esophagus

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show abstract

“…For each unit increase the risk of death decreased by 5%. 10 An investigation of 124 patients treated with radiotherapy or chemoradiotherapy (CRT) for oesophageal cancer found that pre-treatment I Tanswell, H Steed, S Ahmad, J Butterworth, G Townson clinical haemoglobin levels of 12.1-14g/dl were associated with the best overall survival, followed by >14 g/dl and then <12 g/dl (p<0.001). 11 A retrospective investigation of prognostic value of haemoglobin during radiochemotherapy of 108 patients found that haemoglobin levels of greater than 12 g/dl was associated with significantly increased overall survival rates (p=0.002).…”

Section: Discussionmentioning

confidence: 99%

“…10,11,14,16 However most studies are small, many focus on the SCC subtype and a meta-analysis is required to review and clarify the use of haemoglobin as a prognostic factor pre-treatment and during treatment. This analysis fails to demonstrate an association between baseline anaemia and reduced overall survival in the SCC subtype, which supports the findings of Hofheink et al 15 One small study of 56 patients given combined CRT for unresectable oesophageal cancer found 30% of these patients were given blood transfusions during CRT.…”

mentioning

confidence: 99%