Anticancer research · 2026
Preoperative Hemoglobin Level and Iron Status as Predictors of Prognosis in Gastric Cancer Surgery.
СтатьяНазвание и аннотация: Перевод в очереди
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Namikawa Tsutomu, Shinno Kento, Maeda Masahiro, Utsunomiya Masato, Yokota Keiichiro, Fujisawa Kazune, Munekage Masaya, Maeda Hiromichi, Kitagawa Hiroyuki, Ishioka Yoko, Okinaka Yumi, Osaka Kyoko, Seo Satoru
Аннотация
BACKGROUND/AIM: This study aimed to evaluate the association between clinicopathological features, iron status, and prognosis in patients undergoing gastrectomy for gastric cancer.
PATIENTS AND METHODS: We retrospectively analyzed 634 patients who underwent gastrectomy between 2014 and 2023. Anemia was defined by World Health Organization criteria (Hb <12.0 g/dl in women, <13.0 g/dl in men). Survival outcomes were assessed using Kaplan-Meier and Cox proportional hazards models.
RESULTS: Preoperative anemia was present in 61.8% of patients. The 5-year overall survival rate was significantly lower in patients with anemia (62.0% vs. 78.0%; p=0.001) and those receiving blood transfusion (44.7% vs. 73.9%; p<0.001). Multivariate analysis identified stage, age, and comorbidities as independent prognostic factors. Although anemia was not an independent factor considering the entire cohort, stage-stratified analysis revealed that in patients with stage I/II disease, the 5-year overall survival rate was significantly lower in the group with anemia (83.0% vs. 93.8%; p=0.024). Hemoglobin levels were significantly positively correlated with serum iron (r=0.554) and albumin (r=0.555) levels.
CONCLUSION: Preoperative anemia is highly prevalent and significantly associated with poor long-term survival, particularly in stage I/II gastric cancer. As a modifiable risk factor reflecting physiological reserve, preoperative optimization of the hemoglobin level may improve outcomes in this population.
PATIENTS AND METHODS: We retrospectively analyzed 634 patients who underwent gastrectomy between 2014 and 2023. Anemia was defined by World Health Organization criteria (Hb <12.0 g/dl in women, <13.0 g/dl in men). Survival outcomes were assessed using Kaplan-Meier and Cox proportional hazards models.
RESULTS: Preoperative anemia was present in 61.8% of patients. The 5-year overall survival rate was significantly lower in patients with anemia (62.0% vs. 78.0%; p=0.001) and those receiving blood transfusion (44.7% vs. 73.9%; p<0.001). Multivariate analysis identified stage, age, and comorbidities as independent prognostic factors. Although anemia was not an independent factor considering the entire cohort, stage-stratified analysis revealed that in patients with stage I/II disease, the 5-year overall survival rate was significantly lower in the group with anemia (83.0% vs. 93.8%; p=0.024). Hemoglobin levels were significantly positively correlated with serum iron (r=0.554) and albumin (r=0.555) levels.
CONCLUSION: Preoperative anemia is highly prevalent and significantly associated with poor long-term survival, particularly in stage I/II gastric cancer. As a modifiable risk factor reflecting physiological reserve, preoperative optimization of the hemoglobin level may improve outcomes in this population.