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Influence of anemia on tumor response to preoperative chemoradiotherapy for locally advanced rectal cancer

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Abstract

Purpose

In rectal cancer patients treated with preoperative chemoradiotherapy (CRT) and curative resection, we evaluated the influence of anemia on tumor response to preoperative CRT.

Methods

Between August 2001 and July 2007, 490 patients underwent preoperative CRT, followed by curative-intent surgery. Tumor responses were evaluated based on tumor regression grade (TRG), T- and N-level downstaging, and volume reduction rates.

Results

The level of pretreatment hemoglobin (Hb) was 12.9 ± 1.7 g/dl (range, 7.2–17.6 g/dl). Tumor response rates were significantly different below and above the Hb level of 9.0 g/dl. Specifically, patients with Hb levels ≥9.0 g/dl achieved better tumor responses than those with Hb levels < 9.0 g/dl (rates of TRG 3 or 4—29.0% vs. 0%, p < 0.001). In addition, there is no differences in tumor response between the nontransfusion and transfusion groups of patients with Hb levels ≥9.0 g/dl (rates of TRG 3 or 4—29.1% vs. 23.1%, p = 0.445).

Conclusions

The serum Hb level could be a one of prognostic factors that influences the pathologic tumor response, and pretreatment anemia (below 9.0 g/dl of Hb) is associated with poor response to preoperative CRT.

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Authors and Affiliations

  1. Center for Colorectal Cancer, Research Institute & Hospital, National Cancer Center, 111 Jungbalsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do, 410-769, South Korea

    Seong Dae Lee, Ji Won Park, Kui Seon Park, Hee Jin Chang, Dae Yong Kim, Hyo Seong Choi & Jae Hwan Oh

  2. Department of Colon and Rectal Surgery, University of Ulsan College of Medicine and Asan Medical Center, Asanbyeongwon-gil 86, Songpa-gu, Seoul, 138-736, South Korea

    Seok-Byung Lim

  3. Department of Colon and Rectal Surgery, Seoul National University of Medicine, 28 Yeongeon-dong, Jongno-gu, Seoul, 110-744, South Korea

    Seung-Yong Jeong

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  1. Seong Dae Lee
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Correspondence to Jae Hwan Oh.

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Lee, S.D., Park, J.W., Park, K.S. et al. Influence of anemia on tumor response to preoperative chemoradiotherapy for locally advanced rectal cancer. Int J Colorectal Dis 24, 1451–1458 (2009). https://doi.org/10.1007/s00384-009-0762-7

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  • DOI: https://doi.org/10.1007/s00384-009-0762-7

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