Preoperative Anemia Is an Independent Prognostic Factor for Esophageal Cancer Patients Who Receive Curative Treatment.

Background/aim: We retrospectively evaluated the clinical impact of anemia during the perioperative period on both short- and long-term oncological outcomes in patients with resectable esophageal cancer who received curative treatment.

Patients and methods: We retrospectively reviewed the medical records and collected data from consecutive patients with esophageal cancer who underwent curative resection at Yokohama City University from 2005 to 2022.

Results: A total of 198 patients were included in this study. According to previous studies and the 3- and 5- year overall survival rates, a hemoglobin level of 11 g/dl was selected as the optimal cutoff value in the present study; preoperative hemoglobin of <11 g/dl and >11 g/dl were observed in 34 patients (Hb-low group) and 164 patients (Hb-high group), respectively. The 3- and 5-year OS rates were 39.1% and 34.8%, respectively, in the Hb-low group and 70.3% and 62.1% in the Hb-high group. There were significant differences between the two groups (p=0.003). Univariate and multivariate analyses demonstrated that the preoperative Hb level was as an independent prognostic factor for OS [hazard ratio (HR)=1.809; 95% confidence interval (CI)=1.073-3.050, p=0.026]. Moreover, the 3- and 5-year recurrence-free survival (RFS) rates were 16.6% and 16.6%, respectively, in the Hb-low group and 51.8% and 45.1% in the Hb-high group (p<0.001). In the multivariate analysis, the preoperative Hb status was also selected as an independent prognostic factor for RFS (HR=1.977; 95%CI=1.240-3.151 p=0.004).

Conclusion: Preoperative anemia is an independent prognostic factor in patients with esophageal cancer. Our results suggest its potential significance in the treatment and management of these patients.