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| |  Preoperative Anaemia Diminishes Survival After Oesophagectomy for Cancer: Presented at SSO By Jill Stein ST. LOUIS, Mo -- March 6, 2010 -- Preoperative anaemia is independently associated with shorter survival after oesophagectomy for cancer, researchers announced here on March 5 at the 2010 Society of Surgical Oncology Annual Cancer Symposium (SSO). Marcovalerio Melis, MD, New York University School of Medicine, New York, New York, and colleagues measured the effects of preoperative anaemia on short-term surgical outcomes and survival in 541 patients who underwent oesophagectomy during a recent 4-year period. “Combined modality treatment strategies are widely used for patients with oesophageal cancer,” the authors wrote in their poster presentation. “Cisplatin-based chemotherapies are routinely used preoperatively but frequently lead to anaemia.” Preoperative anaemia has been reported to increase risks of perioperative complications and reduce survival for a variety of cancers. Overall, 254 (49.5%) patients were anaemic preoperatively. Anaemia was more common after neoadjuvant treatment (72% vs 41%; P = .001). Anaemia patients presented more frequently with kidney disease (4% vs 1%; P = .01) and advanced oesophageal cancer (stage III-IV, 61% vs 36%; P = .001). Patients with anaemia were also more likely to undergo transhiatal surgery (29% vs 19%; P = .005) and perioperative blood transfusions (58% vs 44%; P = .001). Preoperative anaemia was not associated with an increase in overall or individual symptoms. At a median follow-up of 25 months, the 5-year overall survival and recurrence-free survival were significantly worse in anaemic patients than non-anaemic patients (34% vs 46%; P = .002, and 37% vs 45%; P = .002). In addition, on multivariate analysis, anaemia remained a negative prognostic factor after controlling for stage, administration of neoadjuvant treatment, or blood transfusion. The investigators said that it is still not known whether anaemia per se is the cause of decreased survival or instead represents a surrogate biological marker for aggressive disease or other adverse factors. They added that more studies are needed to determine whether treating anaemia boosts survival. Finally, they noted that their findings parallel earlier reports suggesting that anaemia and resulting hypoxia may favour tumour progression. [Presentation Title: Preoperative Anemia Decreases Survival After Esophagectomy for Cancer. Abstract P178]
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