Aoyama Toru, Hashimoto Itaru, Maezawa Yukio, Esashi Ryuki, Yamamoto Sosuke, Shimada Kiyoko, Kazama Keisuke, Numata Koji, Uchiyama Mamoru, Tamagawa Ayako, Saito Aya, Yukawa Norio
Department of Surgery, Yokohama City University, Yokohama, Japan
Department of Surgery, Yokohama City University, Yokohama, Japan.
Anticancer Res. 2024 Dec;44(12):5551-5557. doi: 10.21873/anticanres.17381.
BACKGROUND/AIM: This study evaluated the clinical impact of anemia during the perioperative period on both short- and long-term oncological outcomes in resectable gastric cancer (GC) patients who received curative treatment.
We conducted a retrospective review of medical records and collected data from consecutive patients with gastric cancer who underwent curative resection at Yokohama City University between 2015 and 2022.
A total of 330 patients were evaluated in this study. In the present study, we set the cutoff value of preoperative hemoglobin at 11.0 g/dl. The 1-, 3-, and 5-year overall survival rates were 88.6%, 59.8%, and 47.0%, respectively, in patients with hemoglobin levels <11 g/dl, and 96.8%, 86.0%, and 80.0% in those with hemoglobin levels ≥11 g/dl. Based on univariate and multivariate analyses, the preoperative hemoglobin status was identified as an independent prognostic factor for both overall survival (hazard ratio=1.772, 95% confidence interval=1.109-2.831, p=0.017) and recurrence-free survival (hazard ratio=1.782; 95% confidence interval=1.166-2.723, p=0.008). In addition, perioperative anemia was also found to affect the clinical course of postoperative surgical complications and postoperative adjuvant chemotherapy.
Perioperative anemia was identified as an independent prognostic factor in GC patients who received curative treatment. To improve the survival of patients with GC, it is necessary to provide care and management for perioperative anemia before curative treatment.
背景/目的：本研究评估了接受根治性治疗的可切除胃癌（GC）患者围手术期贫血对短期和长期肿瘤学结局的临床影响。
我们对病历进行了回顾性分析，并收集了2015年至2022年在横滨市立大学接受根治性切除术的连续胃癌患者的数据。
本研究共评估了330例患者。在本研究中，我们将术前血红蛋白的临界值设定为11.0 g/dl。血红蛋白水平<11 g/dl的患者1年、3年和5年总生存率分别为88.6%、59.8%和47.0%，而血红蛋白水平≥11 g/dl的患者分别为96.8%、86.0%和80.0%。基于单因素和多因素分析，术前血红蛋白状态被确定为总生存（风险比=1.772，95%置信区间=1.109 - 2.831，p = 0.017）和无复发生存（风险比=1.782；95%置信区间=1.166 - 2.723，p = 0.008）的独立预后因素。此外，还发现围手术期贫血会影响术后手术并发症的临床过程和术后辅助化疗。
围手术期贫血被确定为接受根治性治疗的GC患者的独立预后因素。为提高GC患者的生存率，有必要在根治性治疗前对围手术期贫血进行护理和管理。
