The Prognostic Significance of Preoperative Anemia in Gastric Cancer Patients

Abstract

Background/Aim: This study aimed to investigate the prognostic significance of preoperative anemia in gastric cancer patients. Patients and Methods: The medical records of 801 patients with gastric cancer who underwent gastrectomy at the Nara Medical University hospital, were reviewed. Anemia was defined as a hemoglobin (Hb) level of <10 g/dl. Multivariate analysis was performed to identify prognostic factors. Results: The mean Hb level was 13.1 (SD=2.0). Sixty-four (8.0%) patients were classified into the anemic group. Anemic patients were significantly older than nonanemic patients (p=0.007). Anemia was significantly associated with cardiovascular disease (p=0.041), chronic renal failure (p<0.001), tumor depth (p<0.001), and lymph node metastasis (p=0.001). The overall survival (OS) and cause-specific survival (CSS) rates of anemic patients were significantly lower in comparison to the nonanemic patients (p<0.001). In a subgroup analysis, the OS rate of anemic patients was significantly lower than that of nonanemic patients among patients with stage I and stage II disease. According to a multivariate analysis, preoperative anemia was an independent prognostic factor for OS (p<0.001), but not CSS (p=0.555). The rate of non-cancer deaths among anemic patients was significantly higher than that among nonanemic patients (p<0.001). Conclusion: Preoperative anemia is a simple and reliable predictor of poor prognosis, and it is associated with a higher risk of non-cancer death.

Preoperative abnormal bone mineral density as a prognostic indicator in patients undergoing gastrectomy for gastric cancer: A cohort study

“…[1,2] Anemia, a common manifestation in patients with GC, also emerged as a significant independent prognostic factor for OS, reflecting its role as an indicator of malnourishment and tumor-related bleeding. [57] Finally, ALB level, a pivotal nutritional marker, demonstrated its significance in determining OS, underscoring the importance of early nutritional evaluation and management in improving outcomes for patients with GC. [55] Collectively, these 6 variables integrated into the FM offer a comprehensive approach to predicting OS in patients with GC, providing valuable insights for risk stratification and personalized therapeutic strategies.…”

Prognostic Significance of Degree of Anaemia and Blood Transfusions in Gastric Cancer Patients

“…A number of studies have assessed preoperative haemoglobin levels and associated morbidity and mortality in patients with gastric cancer. Preoperative anaemia was associated with poor overall survival in stage I, II and III gastric cancer patients [11,12]. In a meta-analysis of Seventeen studies involving 13,154 gastric cancer patients, preoperative anaemia was identified in 36% of patients.…”

“…It has been hypothesised that tumour hypoxia due to low haemoglobin (Hb) level leads to tumour growth and resistance to therapy as it can lead to angiogenesis, resistance to apoptosis, and a resistance to free radicals from chemotherapy and radiotherapy [8,9]. Several studies have reported anaemia as an independent prognostic factor in patients undergoing surgery for gastric cancer [10,11,12]; however fewer have focused on the prognostic effect of anaemia in patients with advanced metastatic gastric cancer [13,14]. We conducted this study to evaluate the impact of anaemia and blood transfusion on clinical outcomes including progression free survival (PFS) and overall survival (OS) in patients with gastric cancer.…”