Quantitative data on red cell measures of iron status and their relation to the magnitude of the systemic inflammatory response and survival in patients with colorectal cancer

McSorley, Stephen T.; Tham, Alexander; Steele, Colin W.; Dolan, Ross D.; Roxburgh, Campbell S.D.; Horgan, Paul G.

doi:10.1016/j.ejso.2019.02.027

Cited by 6 publications

(10 citation statements)

References 18 publications

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“…Recently, alcohol consumption was found to be strongly associated with poor prognosis of HNSCC overall, with its impact being higher in patients submitted to radiation treatment compared to those receiving surgery 19 . However, this would not explain why the combination of macrocytosis and anemia does not have an impact on survival 11 . Moreover, in our study, the estimated HRs are independent from tobacco smoking.…”

Section: Discussioncontrasting

confidence: 70%

“…Furthermore, anemia, and particularly nonmicrocytic anemia, is associated with poorer cancer‐specific and overall survival, independent of systemic inflammation in colorectal cancers 11 . The presence of a host systemic inflammatory response, and red cell markers of iron status are well documented to have a negative prognostic impact 12 …”

Section: Introductionmentioning

confidence: 99%

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Pretreatment High MCV as Adverse Prognostic Marker in Nonanemic Patients with Head and Neck Cancer

et al. 2020

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Objective Mean corpuscular volume (MCV) has been shown in to be a reliable prognostic marker in other cancers; however, no evidence exists on its use in head and neck squamous cell carcinoma (HNSCC). This study aimed to investigate the association between MCV, hemoglobin, platelet count and albumin concentration, and survival in stage III/IVA‐B HNSCC treated with concurrent chemoradiotherapy. Study Design Retrospective cohort study. Methods In this multicenter retrospective study, we analyzed MCV, platelet count, hemoglobin concentration, and albumin concentration in peripheral blood samples from 260 patients with HNSCC undergoing organ preservation treatment with curative intent at the time of diagnosis. We then analyzed survival outcomes after accounting for confounders using multivariate analysis. Results After adjustment for potential confounders, patients with low hemoglobin had a 3.3‐fold higher risk of death (95% confidence interval [CI]: 2.26‐4.81) than those with normal hemoglobin. Patients with an elevated MCV had a 1.54‐fold higher risk of death (95% CI: 1.06‐2.24), independent of site, stage, and human papillomavirus status. Interestingly, the effect of MCV on overall and progression‐free survival was limited to those with a normal pretreatment hemoglobin. We identified no associations between pretreatment platelet count or albumin concentration and survival. Conclusion These findings suggest that pretreatment anemia and macrocytosis are independent predictors of lower overall and progression‐free survival in HNSCC patients undergoing organ preservation treatment. Level of Evidence III Laryngoscope, 131:E836–E843, 2021

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Section: Discussioncontrasting

confidence: 70%

Section: Introductionmentioning

confidence: 99%

Pretreatment High MCV as Adverse Prognostic Marker in Nonanemic Patients with Head and Neck Cancer

et al. 2020

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“…Besides myeloid immune cells, such as granulocytes, monocytes, and MDSCs, common myeloid progenitor cells can differentiate into megakaryocytes and red blood cells. However, instead of erythrocytosis (an increase in the number of red blood cells in the blood), CRC patients frequently have anemia (a decrease in the number of red blood cells or hemoglobin concentration), with a prevalence of 33%-43% in resectable disease[97-99]. Colorectal tumors frequently bleed into the lumen[100], explaining the iron deficiency associated with microcytic anemia in a subset of patients.…”

Section: Effects Of Systemic Inflammation In Crcmentioning

confidence: 99%

“…Colorectal tumors frequently bleed into the lumen[100], explaining the iron deficiency associated with microcytic anemia in a subset of patients. However, systemic inflammation also appears to be one of the main determinants of low blood hemoglobin levels, and, in particular, normocytic anemia, in CRC patients[97-99]. There are several collaborating mechanisms linking systemic inflammation and anemia.…”

Section: Effects Of Systemic Inflammation In Crcmentioning

confidence: 99%

Systemic inflammation in colorectal cancer: Underlying factors, effects, and prognostic significance

Tuomisto

Mäkinen

Väyrynen

2019

WJG

204

181

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Systemic inflammation is a marker of poor prognosis preoperatively present in around 20%-40% of colorectal cancer patients. The hallmarks of systemic inflammation include an increased production of proinflammatory cytokines and acute phase proteins that enter the circulation. While the low-level systemic inflammation is often clinically silent, its consequences are many and may ultimately lead to chronic cancer-associated wasting, cachexia. In this review, we discuss the pathogenesis of cancer-related systemic inflammation, explore the role of systemic inflammation in promoting cancer growth, escaping antitumor defense, and shifting metabolic pathways, and how these changes are related to less favorable outcome.

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“…Although this form of optimisation targets those patients with hypochromic microcytic anaemia of iron deficiency classically associated with gastrointestinal cancers, there is increasing evidence that normocytic anaemia is twice as prevalent (around 20% at diagnosis, compared to 10% with microcytic anaemia) amongst patients diagnosed with colorectal cancer (McSorley et al 2019a). Patients with normocytic anaemia had higher levels of inflammation as measured by modified Glasgow Prognostic Score (mGPS) (McSorley et al 2019b). Furthermore, such normocytic anaemia was associated with poorer outcomes following treatment with curative intent (Vayrynen et al 2018).…”

Section: Introductionmentioning

confidence: 99%

The impact of preoperative systemic inflammation on the efficacy of intravenous iron infusion to correct anaemia prior to surgery for colorectal cancer

et al. 2020

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Aim: Intravenous iron is increasingly used prior to surgery for colorectal cancer (CRC) to correct iron deficiency anaemia and reduce blood transfusion. Its utility in functional iron deficiency (FID) or anaemia of inflammation is less clear. This observational study examined post-iron infusion changes in haemoglobin (Hb) based on grouping by C-reactive protein (CRP) and ferritin. Methods: Anaemic (M:Hb < 130 mg/L, F:Hb < 120 mg/L) patients with CRC receiving iron infusion, within a preoperative anaemia detection and correction protocol, at a single centre between 2016 and 2019 were included. Patients were grouped by iron deficiency (ferritin < 30 μg/L and CRP ≤ 5 mg/L, n = 18), FID (ferritin < 30 μg/L and CRP > 5 mg/L, n = 17), anaemia of inflammation (ferritin ≥ 30 μg/L and CRP > 5 mg/L, n = 6), and anaemia of other causes (ferritin ≥ 30 μg/L and CRP ≤ 5 mg/L, n = 6). Median change in Hb and postoperative day (POD) 1 Hb was compared by Kruskal-Wallis test. Results: Iron-deficient patients had the greatest increase in Hb after infusion (24 mg/L), highest POD 1 Hb (108 mg/ L), and required no blood transfusions. Patients with FID had the second greatest increase in Hb (15 mg/L) and second highest POD 1 Hb (103 mg/L). Those with anaemia of inflammation had little increase in Hb after infusion (3 mg/L) and lower POD 1 Hb (102 mg/L) than either iron-deficient group. Those without iron deficiency showed a decrease in haemoglobin after infusion (− 5 mg/L) and lowest POD 1 Hb (95 mg/L). Conclusions: Preoperative intravenous iron is less efficacious in patients with anaemia of inflammation and FID undergoing surgery for CRC, compared with true iron deficiency. Further understanding of the role of perioperative iron infusions is required for maximum gain from therapy.

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Quantitative data on red cell measures of iron status and their relation to the magnitude of the systemic inflammatory response and survival in patients with colorectal cancer

Abstract: Quantitative data on red cell measures of iron status and their relation to the magnitude of the systemic inflammatory response and survival in patients with colorectal cancer.

Cited by 6 publications

References 18 publications

Pretreatment High MCV as Adverse Prognostic Marker in Nonanemic Patients with Head and Neck Cancer

Pretreatment High MCV as Adverse Prognostic Marker in Nonanemic Patients with Head and Neck Cancer

Systemic inflammation in colorectal cancer: Underlying factors, effects, and prognostic significance

The impact of preoperative systemic inflammation on the efficacy of intravenous iron infusion to correct anaemia prior to surgery for colorectal cancer

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