Iron-deficiency anemia: a predictor of diminished disease-free survival of T3N0M0 stage colon cancer.

PURPOSE: The aim of this study was to determine whether iron-deficiency anemia (IDA) predicts long-term oncologic outcomes in patients with TNM stage II colon cancer.

METHODS

Clinical and follow-up data were extracted from a prospective colon cancer database. Univariate and multivariate analyses were performed to identify IDA and other predictors of long-term oncologic outcomes.

RESULTS

Among 644 patients, 147 (22.8%) patients presented with IDA. The data were stratified by T3N0M0 and T4N0M0. The distribution difference of IDA between the two subsets was not significant (P = 0.340). But in the T4N0M0 subset, the incidence of IDA increased with the depth of tumor penetration (75.9% and 18.2% for the patients with and without adjacent organ involvement, respectively, P = 0.011). IDA predicted a worse disease-free survival among patients with T3N0M0 cancer (472 patients; log-rank test, P = 0.016; Cox regression, P = 0.009), but it was not a predictor in T4N0M0 cancer patients (172 patients; log-rank test, P = 0.016; Cox regression, P > 0.05).

CONCLUSIONS

IDA was an independent predictor of long-term outcome in T3N0M0 stage, but not in T4N0M0 colon cancer. T3N0M0 stage colon cancer patients with IDA could be included in future trials of adjuvant therapies.