Impact of pretreatment hematologic profile on survival of colorectal cancer patients

Qiu, Miao Zhen; Yuan, Zhong Yu; Luo, Hui; Ruan, Dan; Wang, Zhi Qiang; Wang, Feng Hua; Li, Yu Hong; Xu, Rui‐Hua

doi:10.1007/s13277-010-0024-x

Cited by 55 publications

(52 citation statements)

References 25 publications

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“…The most likely explanation for the association between low HB and poor DSS is the presence of macro‐hematuria in larger tumors. Increased levels of inflammatory cytokines, which might suppress the bone marrow, and other multifactorial molecular mechanisms could also be accountable for the association . The present study showed significant nutritional deficiency, as estimated by the albumin level and BMI in the low HB group (<10.5 g/dL).…”

Section: Discussionsupporting

confidence: 48%

Prognostic impact of preoperative hematological disorders and a risk stratification model in bladder cancer patients treated with radical cystectomy

et al. 2013

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Abbreviations & Acronyms ASA = American Society of Anesthesiologists BCa = bladder cancer BMI = body mass index CCI = Charlson Comorbidity Index CI = confidential interval CRP = C-reactive protein DSS = disease-specific survival ECOG = Eastern Cooperative Oncology Group eGFR = estimated glomerular filtration rate HB = hemoglobin HR = hazard ratio LDH = lactate dehydrogenase LNM = lymph node metastasis LVI = lympho-vascular invasion NA = not available PS = performance status PSM = positive surgical margin RC = radical cystectomy SD = standard deviation Objectives: The present study investigated prognostic indicators, including clinicopathological and preoperative hematological factors, and developed a prognostic factorbased risk stratification model in bladder cancer patients treated with radical cystectomy. Methods: Data were collected from 249 consecutive bladder cancer patients treated with radical cystectomy without neoadjuvant therapy. Prognostic values of the preoperative hematological parameters, along with the patients' clinicopathological parameters were evaluated. A risk stratification model was developed to predict disease-specific survival after radical cystectomy using the regression coefficients of multivariate analysis. Results: In the multivariate analysis, preoperative hemoglobin and C-reactive protein levels, as well as the pathological factors of T stage, positive surgical margin and lymph node metastasis, were independently predictive of disease-specific survival. Low hemoglobin (<10.5 g/dL), a high C-reactive protein (>0.5 mg/dL), extravesical T stage (≥pT3a) and positive surgical margin were independent predictors of poor disease-specific survival. The risk stratification model showed significant differences in disease-specific survival between the three subgroups. Conclusions: This is the first report to show the significance of combining preoperative hemoglobin with the pathology of radical cystectomy specimens as an independent predictor for disease-specific survival, and it also represents the largest contemporary series to date demonstrating that two types of preoperative hematological disorders, assessed by hemoglobin and C-reactive protein, are independent predictors in bladder cancer patients treated with radical cystectomy. Our risk stratification model could provide physicians with useful prognostic information for identifying patients who might be candidates for multimodal treatments.

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Section: Discussionsupporting

confidence: 48%

Prognostic impact of preoperative hematological disorders and a risk stratification model in bladder cancer patients treated with radical cystectomy

et al. 2013

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“…We have previously [23] shown that the percentages of leukocytosis, anemia, and thrombocytosis were significantly higher in colorectal cancer patients than in patients with benign diseases. Moreover, we found that both pretreatment anemia and thrombocytosis were independent prognostic variables for survival of colorectal cancer patients.…”

Section: Introductionmentioning

confidence: 89%

“…A similar phenomenon was found in the condition of anemia and leukocytosis. The incidence rates of anemia and leukocytosis in patients with solid tumors were in a range of 9% to 42.6% [7,22] and 7.4% to 39.0% [7,22,23], respectively.…”

Section: Introductionmentioning

confidence: 99%

Incidence of anemia, leukocytosis, and thrombocytosis in patients with solid tumors in China

Qiu

Ruan

et al. 2010

Tumor Biol.

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Despite the fact that malignancies are associated with hematological abnormalities, some clinical studies have been unable to detect such a relation. The aim of our study was to detect the prevalence of pretreatment hematologic abnormalities in patients with common solid tumors and to determine if such a profile could be used for prognostic evaluations. We identified all patients in Cancer Center of Sun Yat-sen University who were diagnosed as solid tumors (breast carcinoma, hepatocellular carcinoma, nasopharyngeal carcinoma, esophageal carcinoma, gastric cancer, cervical carcinoma, endometrial cancer, renal cell carcinoma, and non-small cell lung cancer) between January 2000 and August 2009. All subjects were investigated regarding levels of white blood cells, platelets, and hemoglobin concentration. We identified 3,180 patients with solid tumors and 285 patients with benign diseases for the final analysis. The percentages of leukocytosis, anemia, and thrombocytosis in patients with solid tumors ranged from 4.0% to 25.6%, 3.3% to 29.2%, and 2.1% to 9.7%, respectively. The multivariate Cox analysis revealed that anemia was an independent prognostic factor in patients with breast cancer (P = 0.006), hepatocellular carcinoma (P = 0.002), nasopharyngeal carcinoma (P = 0.008), and esophageal carcinoma (P = 0.001). Leukocytosis was an independent prognostic factor in patients with cervical cancer (P = 0.007). The incidence of hematological abnormalities in Chinese patients with solid tumors was relatively lower than that of the counterparts in the Western countries. A pretreatment anemia or leukocytosis can serve as a useful marker to predict outcome of patients in some of the solid tumors.

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“…In the 70–79 years age group, leukocytosis was an independent prognostic factor. There was some evidence that leukocytosis is an independent prognostic factor in solid tumors such as cervical cancer, colon cancer and lung cancer [23,24,25]. Trivanovic et al [26] also showed that leukocytosis is a poor prognostic factor using univarinate, but not mutivarinate, Cox regression.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Prognosis for Carcinoma of Unknown Origin in Elderly Patients

Chen

Tzeng

et al. 2012

Oncology

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Purpose: Carcinoma of unknown origin has a poor outcome and usually occurs in elderly patients. In this article, we analyzed the prognostic factors in elderly patients with cancer of unknown primary site (CUP) for treatment considerations. Patients and Methods: Patients >70 years old with histologically proven carcinoma were retrospectively reviewed. The prognostic factors were analyzed with univariate and multivariate Cox regression. Results: We included 63 patients aged 70–79 years and 51 patients ≥80 years old. The results of multivariate Cox regression in the 70–79 years age group revealed white blood cell count ≤10⁴/ml [p = 0.033; hazard ratio (HR) 2.51, range 1.079–5.840] and albumin ≥3.5 g/dl (p = 0.007; HR 3.38, range 1.398–8.177) as independent factors. In the group of patients ≥80 years old, Eastern Cooperative Oncology Group performance status <1 (p = 0.020), white blood cell count ≤10⁴/ml (p = 0.001), albumin ≥3.5 g/dl (p = 0.006), lactate dehydrogenase (LDH) ≤250 U/l (p = 0.002) and non-chest metastasis (p = 0.043) were significantly better with univariate analysis. Multivariate Cox regression revealed albumin ≥3.5 g/dl (p = 0.007; HR 3.28, range 1.389–7.745) and LDH ≤250 U/l (p = 0.045; HR 3.18, range 1.026–9.848) as independent factors. Conclusions: For elderly patients with CUP, the serum albumin level seems to be a consistently independent prognostic factor. In patients >80 years old, serum LDH plays an important role in prognosis. This study is helpful in predicting the outcome and management for this group of patients.

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Impact of pretreatment hematologic profile on survival of colorectal cancer patients

Cited by 55 publications

References 25 publications

Prognostic impact of preoperative hematological disorders and a risk stratification model in bladder cancer patients treated with radical cystectomy

Prognostic impact of preoperative hematological disorders and a risk stratification model in bladder cancer patients treated with radical cystectomy

Incidence of anemia, leukocytosis, and thrombocytosis in patients with solid tumors in China

Evaluation of Prognosis for Carcinoma of Unknown Origin in Elderly Patients

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