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

Scand J Gastroenterol. 2013 Jun;48(6):663-71. doi: 10.3109/00365521.2013.781216. Epub 2013 Mar 27.

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.

Conclusion: 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.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Age Factors
  • Aged
  • Aged, 80 and over
  • Anemia, Iron-Deficiency / blood*
  • Anemia, Iron-Deficiency / etiology*
  • Body Mass Index
  • Colonic Neoplasms / complications
  • Colonic Neoplasms / pathology*
  • Colonic Neoplasms / surgery*
  • Female
  • Hemoglobins / metabolism
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Norway
  • Postoperative Period
  • Preoperative Period
  • Prospective Studies
  • Serum Albumin / metabolism
  • Sex Factors

Substances

  • Hemoglobins
  • Serum Albumin