Is Intravenous Iron Useful for Reducing Transfusions in Surgically Treated Colorectal Cancer Patients?

Titos-Arcos, JC; Soria-Aledo, Víctor; Carrillo-Alcaraz, Andrés; Ventura-López, M; Palacios-Muñoz, Sonsoles; Pellicer-Franco, Enrique

doi:10.1007/s00268-012-1589-x

Cited by 16 publications

(10 citation statements)

References 24 publications

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“…In all these studies, patients were anemic before treatment (mean Hb level at baseline 9.5 g %) and in all the level of Hb was reevaluated after therapy (in most after a month). With only one exception [22], a statistically significant increase of the Hb level was observed (mean Hb increase: 1.6 g %). That increase of the Hb level was clearly superior to that observed in controls in two studies [18,19].…”

Section: Discussionmentioning

confidence: 83%

“…In most of the studies reported here, no sufficient data are provided to separate between absolute and functional iron deficiency and it is likely that the iron deficiency anemia was multifactorial in many patients, namely blood losses in the surgical series [17,19,21,22]. Therefore, it is not surprising that iron supplementation was effective, although the only negative study [22] was conducted in operated colon cancer patients.…”

Section: Discussionmentioning

confidence: 96%

“…In our review, we had only two such studies both in operated colon cancer patients. In anemic patients receiving IV iron preoperatively, there was a significant reduction in the need of transfusion [19]; in a study where patients received IV iron postoperatively, no benefit was observed [22].…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, it is not surprising that iron supplementation was effective, although the only negative study [22] was conducted in operated colon cancer patients. Two of these studies addressed specifically anemic cancer patients whose anemia was likely due to functional iron deficiency [16,18]; although both are small studies, a significantly positive result in terms of Hb rise was reported.…”

Section: Discussionmentioning

confidence: 99%

“…Titos-Arcos et al [22] evaluated IV iron in 71 paired patients after colon cancer surgery. The mean hemoglobin levels were similar in both groups and the rate of blood transfusions was also similar (30%).…”

Section: Introductionmentioning

confidence: 99%

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Intravenous iron therapy for anemic cancer patients: a review of recently published clinical studies

Lebrun

Klastersky

Levacq

et al. 2017

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Based on available literature and on the present review, IV iron administration to anemic cancer patients can increase significantly the level of Hb, probably independently from the precise mechanism of anemia itself. However, in future studies, the benefit should be evaluated taking into account whether the anemia is due to absolute or functional iron deficiency; therapeutic modalities might be different for these two conditions. Along the same lines, it appears important to further evaluate the respective roles of PO and IV iron therapies and the modalities of their use in clinical practice. Until the results of such studies are available, it appears reasonable to propose IV iron therapy to anemic cancer patients as the resulting rise of Hb level may increase their quality of life and performance status and reduce the need for erythropoietinstimulating agents and/or blood transfusions.

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Section: Discussionmentioning

confidence: 83%

Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Intravenous iron therapy for anemic cancer patients: a review of recently published clinical studies

Lebrun

Klastersky

Levacq

et al. 2017

Support Care Cancer

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The Effect of Perioperative Iron Therapy in Acute Major Non‐cardiac Surgery on Allogenic Blood Transfusion and Postoperative Haemoglobin Levels: A Systematic Review and Meta‐analysis

et al. 2019

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Background Perioperative anaemia in relation to surgery is associated with adverse clinical outcomes. In an elective surgical setting, it is possible to optimize patients prior to surgery, often by iron supplementation with correction of anaemia. Possibilities for optimization prior to and during acute surgical procedures are limited. This review investigates whether iron treatment initiated perioperatively improves outcomes in patients undergoing major acute non‐cardiac surgery. Method This systematic review was performed using PubMed, EMBASE (Ovid) and Scopus to identify current evidence on iron supplementation in acute surgery. Primary outcomes were allogenic blood transfusion (ABT) rate and changes in haemoglobin. Secondary outcomes were postoperative mortality, length of stay (LOS), and postoperative complications. Iron was administered at latest within 24 h after end of surgery. Results Of the 5413 studies screened, four randomized controlled trials and nine observational cohort studies were included. Ten studies included patients with hip fractures. A meta‐analysis of seven studies showed a risk reduction of transfusion (OR = 0.35 CI 95% (0.20–0.63), p = 0.0004, I2 = 66%). No influence on plasma haemoglobin was found. Postoperative mortality was reduced in the iron therapy group in a meta‐analysis of four observational studies (OR 0.50 (CI 95% 0.26–0.96) p = 0.04). No effect was found on LOS, but a reduction in postoperative infection was seen in four studies. Conclusions This review examined perioperative iron therapy in acute major non‐cardiac surgery. IV iron showed a lower 30‐day mortality, a reduction in postoperative infections and a reduction in ABT largely due to the observational studies. The review primarily consisted of small observational studies and does not have the power to formally recommend this practice.

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Management of anemia and iron deficiency in patients undergoing corectal surgery

Benhamou

Tănase

2015

Colon Rectum

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Is Intravenous Iron Useful for Reducing Transfusions in Surgically Treated Colorectal Cancer Patients?

Cited by 16 publications

References 24 publications

Intravenous iron therapy for anemic cancer patients: a review of recently published clinical studies

Intravenous iron therapy for anemic cancer patients: a review of recently published clinical studies

The Effect of Perioperative Iron Therapy in Acute Major Non‐cardiac Surgery on Allogenic Blood Transfusion and Postoperative Haemoglobin Levels: A Systematic Review and Meta‐analysis

Management of anemia and iron deficiency in patients undergoing corectal surgery

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