Background
Improving the haemoglobin levels preoperatively leads to a reduction in transfusions required. Intravenous iron III sucrose (IVI), with a good safety profile, represents a new therapeutic option for the treatment of anaemia.
Purpose
To determine whether IVI administration in postoperative colorectal cancer (CRC) decreases the number of transfusions required.
Materials and methods
Retrospective case-control study in patients undergoing CRC surgery in the years 2008, 2009 and 2010, matched by age (±3 years), sex, type of surgery, tumour stage and surgical approach.
Variables recorded: sex, age, tumour location, tumour stage, type of surgery, surgical approach, haemoglobin prior to surgery (Hbs) and at discharge (Hbd), number of transfusions after surgery (Ts) and doses of IVI received. Statistical analysis: Pearson's χ2 test or Fisher's exact test and Student's t or Mann-Whitney test using SPSS 15.0. software.
Results
The number of patients was 342, of which 104 were paired into 2 groups of 52 patients (G1-IVI treated and G2-IVI untreated), 33 men and 19 women per group, with a mean age of 70.9±11.1 and 70.6±10.9 years, respectively. Tumour location in both groups: rectum (25/22), left colon (15/17), and right colon (12/13). Tumour stage in both groups: III in 36.5%, 0 in 26.9%, IV in 13.5%, I in 11.5% and II in 11.5%. Type of surgical procedure in both groups: anterior resection of rectum in 36.4%, left and right colectomy in 28.8% and 21.2%, respectively. Surgical approach: 92.3% by laparotomy and 7.7% by laparoscopy. Hbs was 12.3±1.6 g/dl (G1) and 12.8±1.9 µg/dl (G2)(p=0.133), and Hbd was 10±1.1 g/dl (G1) and 10.6±1.2 µg/dl (G2)(p=0.012). Ts was 3±1.6 (G1) and 3.3±3 (G2)(p=0.682). 28.8% and 30.8% in groups 1 and 2, respectively, were transfused (p=0.830). The mean dose of IVI was 592±445 mg.
Conclusions
Administration of IVI does not appear to decrease transfusion requirements, possibly because bone marrow physiologically requires a period longer than the hospital stay to increase haemoglobin levels. Additional studies are needed to show more clearly the value of IVI.
