A retrospective study: the prognostic value of anemia, smoking and drinking in esophageal squamous cell carcinoma with primary radiotherapy

Abstract

BackgroundFew studies have investigated the relationship between anemia, smoking, drinking and survival in esophageal squamous cell carcinoma (ESCC) with primary radiotherapy. This study had the aim of evaluating the prognostic value of anemia, smoking and drinking in patients receiving primary radiotherapy for ESCC.MethodsA total of 79 patients who underwent radiotherapy during initial treatment for ESCC were included in this study. The 2-year overall survival (OS) and disease-free survival (DFS) were analyzed between the anemic and non-anemic groups, non-smokers and smokers, and non-drinkers and drinkers using the Kaplan-Meier method and the Cox proportional hazards model.ResultsThere were 79 patients (10 male) of median age 63 (range 38 to 84) years. The 2-year OS and DFS were 36% and 25%, respectively, in the non-anemic group, and 17% and 13%, respectively, in the anemic group (P = 0.019 for OS; P = 0.029 for DFS) using the Kaplan-Meier method. Survival analysis using the Kaplan-Meier method showed that the 2-year OS and DFS had no statistical difference between smoking, drinking and survival. In a univariate analysis, anemia was identified as a significant prognostic factor for 2-year OS (hazard ratio (HR) = 1.897; P = 0.024) and 2-year DFS (HR = 1.776; P = 0.036), independent of tumor, lymph node, metastasis (TNM) stage. In a multivariate analysis, anemia was identified as a highly significant prognostic factor for 2-year OS (HR = 2.125; P = 0.011) and 2-year DFS (HR = 1.898; P = 0.025), independent of TNM stage and initial treatment. We found no statistical difference in the 2-year OS and DFS associated with smoking (P > 0.2) and drinking (P > 0.6) using univariate and multivariate analysis.ConclusionsSmoking and drinking were not prognostic for 2-year OS or DFS. Anemia before radiotherapy was associated with poor prognosis and an increased risk of relapse, which may serve as a new prognostic characteristic in ESCC treated with primary radiotherapy. Hemoglobin is a routine examination and anemia is therefore simple and quick to determine.

Lack of any Prognostic Value of Body Mass Index for Patients Undergoing Chemoradiotherapy for Esophageal Squamous Cell Carcinoma

“…were similar to those of previous studies (Samadi et al, 2007;Kandaz et al, 2012;Schoppmann et al, 2013;Zhang et al, 2013).…”

The ratio of hemoglobin to red cell distribution width as a novel prognostic parameter in esophageal squamous cell carcinoma: a retrospective study from southern China

“…The prognostic value of the RDW/platelet ratio in myocardial infarction was also discussed [40, 41]. As HB is a well-established nutritional indicator and a potential prognostic factor in ESCC [16–19, 21, 22], we combined HB and RDW and built a novel prognostic index—the HB/RDW ratio.…”

“…Low HB levels could reflect malnutrition in the host and the host immune status to some extent, both of which may indicate low tolerance to treatment. Several studies have demonstrated that anemia before treatment was a predictor of poor outcome in cancer patients, including patients with nasopharyngeal carcinoma, head and neck cancer, cervical cancer, ESCC and gastrointestinal cancer [16–19, 21, 22]. …”

Do smoking and alcohol behaviours influence GI cancer survival?

“…We identified a total of 20 studies [9,[49][50][51][52][53][54][55][56][57][58][59][60][61][62][63][64][65] which investigated the impact of smoking on survival in patients diagnosed with oesophageal cancer (Supplementary table 2). Most studies were singlecentred and focused on patients with oesophageal squamous cell carcinoma.…”