Impact of anaemia in oesophago-gastric cancer patients undergoing curative treatment by means of neoadjuvant chemotherapy and surgery

Chan, B. Y.L., McKinlay, S., Forshaw, M., Macdonald, A., Maitra, R., Orizu, M. and McSorley, S. T. (2021) Impact of anaemia in oesophago-gastric cancer patients undergoing curative treatment by means of neoadjuvant chemotherapy and surgery. Surgical Oncology, 38, 101585. (doi: 10.1016/j.suronc.2021.101585) (PMID:33930843)

Abstract

Background: The present study investigated factors associated with pre-neoadjuvant chemotherapy (NAC), and pre-operative anaemia, and examined their impact on outcomes in patients with oesophago-gastric cancer treated with curative intent. Methods: Patients diagnosed with oesophago-gastric cancer (January 2010 to December 2015) and treated with curative intent by NAC then surgery at a tertiary centre were included. Patients were grouped by the presence of anaemia (haemoglobin <130 mg/L in males and <120 mg/L in females) and into microcytic (MCV <80 fL), normocytic (80–100 fL) and macrocytic (>100 fL) subgroups. Categorical data were analysed by chi-squared test and overall survival by univariate and multivariate Cox regression. Results: 99/295 (34%) patients who received NAC were diagnosed with pre-NAC anaemia, and 157/268 (59%) of patients who subsequently underwent surgery were diagnosed with pre-operative anaemia. Normocytic anaemia was the most common, with 76 (26%) in pre-NAC and 107 (40%) in pre-operative groups. Pre-NAC anaemia was associated with increasing clinical N stage (p = 0.022), higher modified Glasgow Prognostic Score (mGPS) (p = 0.006), and a higher rate of intra-operative transfusion (p = 0.030). Pre-operative anaemia was associated with pre-NAC anaemia (p = 0.004), increasing age (p = 0.026), higher pre-operative mGPS (p = 0.021), and a higher rate of intra-operative transfusion (p = 0.021). Anaemia before NAC and surgery was associated with poorer overall survival in patient following R0 resection, independent of stage (HR 1.26, 95% CI 1.02–1.54, p = 0.030). Conclusion: Anaemia was associated with poorer overall survival and greater requirement for intra-operative blood transfusion in oesophago-gastric cancer patients undergoing treatment with curative intent.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Forshaw, Mr Matthew and McKinlay, Dr Sonya and McSorley, Dr Stephen
• Authors: Chan, B. Y.L., McKinlay, S., Forshaw, M., Macdonald, A., Maitra, R., Orizu, M., and McSorley, S. T.
• College/School: College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
• Journal Name: Surgical Oncology
• Publisher: Elsevier
• ISSN: 0960-7404
• ISSN (Online): 1879-3320
• Published Online: 22 April 2021
• Copyright Holders: Copyright © 2021 Elsevier
• First Published: First published in Surgical Oncology 38: 101585
• Publisher Policy: Reproduced in accordance with the copyright policy of the publisher