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

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.

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.

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).

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.