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Annals of Oncology Advance Access originally published online on September 12, 2006
Annals of Oncology 2006 17(11):1661-1664; doi:10.1093/annonc/mdl285
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© 2006 European Society for Medical Oncology

gastrointestinal tumors

Anemia may influence the outcome of patients undergoing neo-adjuvant treatment of rectal cancer

R Berardi1,*, C Braconi1, G Mantello1, M Scartozzi1, S Del Prete1, G Luppi2, R Martinelli3, M Fumagalli3, G Valeri4, I Bearzi5, C Marmovale6, F Grillö-Ruggieri1 and S Cascinu1

1 Department of Oncology and Radiotherapy, Azienda Ospedaliero-Universitaria Ospedali Riuniti Umberto I—GM Lancisi—G Salesi di Ancona, Italy
2 Radiotherapy, Università di Modena, Italy
3 Radiotherapy, Università di Parma, Italy
4 U.O. di Anatomia Patologica, Università Politecnica delle Marche, Azienda Ospedaliero-Universitaria Ospedali Riuniti Umberto I—GM Lancisi—G Salesi di Ancona, Italy
5 Department of Radiology, Università Politecnica delle Marche, Azienda Ospedaliero-Universitaria Ospedali Riuniti Umberto I—GM Lancisi—G Salesi di Ancona, Italy
6 Clinica di Chirurgia Generale, Università Politecnica delle Marche, Azienda Ospedaliero-Universitaria Ospedali Riuniti Umberto I—GM Lancisi—G Salesi di Ancona, Italy

*Correspondence to: Dr R. Berardi, Medical Oncology Unit, Università Politecnica delle Marche, Azienda Ospedaliero-Universitaria Ospedali Riuniti Umberto I—GM Lancisi—G Salesi di Ancona, Via Conca 71, 60020 Ancona, Italy. Tel: +39 071 5964169; Fax +39 071 5964192; E-mail: r.berardi{at}univpm.it

Background: We hypothesized that anemia could represent one of the major factors influencing the outcome of patients undergoing neo-adjuvant treatment of rectal cancer.

Patients and methods: This analysis included all the consecutive patients who underwent neo-adjuvant treatment (chemotherapy and/or radiotherapy) before surgery for rectal cancer in three oncology/radiotherapy departments from June 1996 to December 2003.

Results: Three hundred and seventeen patients were eligible for our analysis. Median age at diagnosis was 64 years (range 26–88 years); male/female ratio was 184/133. Two hundred and eighty-five patients (89.9%) were diagnosed with adenocarcinoma, while 32/317 (10.1%) with mucinous adenocarcinoma. Neo-adjuvant treatments carried out were as follows: radiotherapy alone in 75/317 patients (23.7%), radiotherapy plus chemotherapy in 242/317 patients (76.3%). At univariate and multivariate analysis, only the hemoglobin (Hb) level (group 1: ≤12 g/dl versus group 2: >12 g/dl) resulted in a significant factor for disease-free survival. The role of the Hb level seemed to be confirmed further by the clinical downstaging obtained in ~55% of patients in group 2, in comparison with 35% of the patients achieving a significant downstaging in group 1.

Conclusion: Our results indicated that anemia could represent an important parameter able to influence the outcome in patients receiving neo-adjuvant treatment of rectal cancer.

Key words: rectal cancer, anemia, prognostic factors


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