Efficacy of Intravenous Ferric Carboxymaltose in Patients with Acute Post-Operative Anemia after Colorectal Cancer Surgery

Purpose: This study evaluated the efficacy of administering intravenous ferric carboxymaltose (Ferinject ® ) in patients with acute post-operative anemia after colorectal surgery. Materials and Methods: Patients with colorectal cancer, who underwent colectomy from January 2017 to July 2019 at the Samsung Medical Center, were retrospectively reviewed. Depending on their body weight, patients were administered 500 mg or 1000 mg of ferric carboxymaltose (ferric carboxymaltose group, 92 patients). The primary outcome evaluated was serum hemoglobin level on post-operative day 21. The secondary outcome was the number of hemoglobin responders, defined as the proportion of patients with normalized serum hemoglobin on post-operative day 21 (hemoglobin level of 12 g/dL or more for male, 11 g/dL or more for female), and a serum hemoglobin increase of 2 g/dL or more from baseline (day 0). Results: Of the 560 patients who underwent colectomy, 92 patients (median age, 67 years; women 59.8%; mean baseline hemoglobin level 10.7 g/dL) received intravenous ferric carboxymaltose. Compared with the no-ferric carboxymaltose group, patients in the ferric carboxymaltose group experienced significantly greater improvement in serum hemoglobin level (post-operative day 5: 8.9 g/dL, P=0.09; post-operative day 21: 11.7 g/dL, P=0.006). The increase in hemoglobin levels was significantly greater in the ferric carboxymaltose group (2.7 g/dL) than the no-ferric carboxymaltose group (2.1 g/dL) (P=0.002). Conclusion: Findings of this study indicate a better outcome after administering intravenous ferric carboxymaltose, which results in continuous increase in the levels of hemoglobin during the early post-operative period after colorectal cancer surgery.