Evaluation of anemia and iron status in Japanese patients with gynecological malignancy: retrospective cohort study

Anemia and iron deficiency are common among patients with cancer and can have a significant impact on their prognosis. However, the current status of anemia and iron deficiency in Japanese patients with gynecological malignancies remains unclear. This study aimed to clarify the prevalence of anemia and iron deficiency at the time of diagnosis and to evaluate their influence on hemoglobin levels during cancer treatment in Japanese patients with gynecological malignancies.

Eligible patients were those diagnosed with gynecological cancers. Anemia and iron status were evaluated before and within 6 months of initiating cancer treatments at our institution between January 2022 and July 2024. Statistical comparison of risk factors was performed with the Mann-Whitney U test, Student t-test, and one-way analysis of variance. Iron status and transferrin saturation (TSAT) were classified using the National Comprehensive Cancer Network guidelines.

A total of 103 patients were assessed for eligibility. The median (interquartile range) hemoglobin level was 12.5 (10.6-13.2) g/dL, and 29.1% of patients had hemoglobin ≤ 11.0 g/dL before cancer treatment. TSAT < 20% and < 50% accounted for 46.7% and 99.0% of patients, respectively; 9.9% and 11.1% were classified as having absolute and functional iron deficiency anemia, respectively. Sixty-two patients received chemotherapy or concurrent chemoradiotherapy for their cancers, and 90.3% developed anemia within 6 months of initiation of treatment. Lower hemoglobin and serum ferritin before treatment, as well as hemoglobin at its lowest point within 6 months of treatment, were found in patients with TSAT < 20%.

Anemia and iron deficiency were prevalent among Japanese patients with gynecological cancers. TSAT < 20% before treatment was associated with more severe anemia during treatment. TSAT may be a useful biomarker for predicting and managing treatment-related anemia. Early intervention based on TSAT levels could help maintain hemoglobin levels and prevent treatment interruption.