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Ann Thorac Surg 2004;78:1037-1041
© 2004 The Society of Thoracic Surgeons

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Original article: general thoracic

Incidence of anemia in patients receiving neoadjuvant chemotherapy for locally advanced esophagogastric cancer

^a Centre Hospitalier Universitaire Vaudois, Multidisciplinary Oncology Center, Lausanne, Switzerland, and Third Medical Department, Klinikum rechts der Isar, Technische Universitaet, Muenchen, Germany
^b Department of Surgery, Klinikum rechts der Isar, Technische Universitaet, Muenchen, Germany
^c Institute for Medical Statistics and Epidemiology, Klinikum rechts der Isar, Technische Universitaet, Muenchen, Germany

Accepted for publication January 22, 2004.

^* Address reprint requests to Dr Voelter, Multidisciplinary Oncology Center, CHUV-BH 06, Rue du Bugnon 46, CH-1011 Lausanne, Switzerland;
verena.voelter{at}hospvd.ch

BACKGROUND: There is rising evidence that anemia and blood transfusion increase perioperative mortality in cancer patients. Patients who are treated with neoadjuvant chemotherapy with a curative intent are exposed to toxicity that may negatively affect their future outcome.

METHODS: The charts of 29 patients (21 males; median age, 59.5 years; range, 37 to 73), receiving neoadjuvant chemotherapy for cT3 esophagogastric adenocarcinoma operated at a single university center in the year 2002, were retrospectively reviewed to assess the incidence of anemia and blood transfusions.

RESULTS: Twenty-six patients received platinum-based chemotherapy over a period of 12 weeks and three patients more than 6 weeks. The median hemoglobin level (Hb level) before chemotherapy was 14.0 g/dL (range, 10.4 to 15.9 g/dL), the median decline of the Hb level was 2.9 g/dL (range, 0.3 to 6.3 g/dL); this drop was statistically significant (p < 0.001, 95% confidence interval). Patients who received preoperative blood transfusions (n = 8, 28%) had a significantly increased risk of developing postoperative complications (p = 0.028).

CONCLUSIONS: Preoperative chemotherapy for locally advanced esophagogastric cancer induces anemia and therefore leads to preoperative blood supplementation in a considerable number of patients. Data indicate that this may counteract the beneficial effects of neoadjuvant treatment.

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				R. S. Weber, N. Jabbour, and R. C. G. Martin II Anemia and Transfusions in Patients Undergoing Surgery for Cancer Ann. Surg. Oncol., January 1, 2008; 15(1): 34 - 45. [Abstract] [Full Text] [PDF]

				K. Abbrederis, F. Bassermann, C. Schuhmacher, V. Voelter, R. Busch, N. Roethling, A. Sendler, J. R. Siewert, C. Peschel, and F. Lordick Erythropoietin-alfa during neoadjuvant chemotherapy for locally advanced esophagogastric adenocarcinoma. Ann. Thorac. Surg., July 1, 2006; 82(1): 293 - 297. [Abstract] [Full Text] [PDF]