The impact of chemotherapy-associated hemoglobin on prognosis of colorectal cancer patients receiving adjuvant chemotherapy

Wei, Yisheng; Zhou, Yue; Wang, Guoying; Liang, Zhihua; Luo, Minrui; Yang, Tian-Ai; Huang, Jun

doi:10.3233/cbm-170601

Cited by 13 publications

(10 citation statements)

References 31 publications

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“…Wei et al . ( 14 ) showed that the baseline platelet count correlated with recurrence in 286 patients with stage II-III CRC receiving adjuvant chemotherapy. The optimal cut-off affecting recurrence was 276×10 9 /L.…”

Section: Discussionmentioning

confidence: 99%

The Role of Complete Blood Count Parameters in Patients with Colorectal Cancer

Mekić

Pedišić

Šobat

et al. 2018

ACC

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SUMMARY – Chronic inflammation has been linked with many cancers. It seems that easily available and usual blood inflammatory markers might serve as a prognostic factor for overall survival and disease-free survival in patients with various cancers. Preoperative neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR), as well as hemoglobinemia, thrombocytosis, elevated C-reactive protein values, neutropenia and leukocytosis have been shown to affect overall survival and disease-free survival in patients with colorectal cancer (CRC), however, with controversial results. Complete blood count, NLR and PLR were determined in 71 patients with CRC (stages 3 and 4) after neoadjuvant chemo-radiotherapy and before surgery, treated at Hospital for Tumors in Zagreb. Statistical analysis included Mann-Whitney U test, Student’s t-test, univariate and multivariate analysis. The results of Mann-Whitney U test and Student’s t-test showed that neutrophil count (p=0.024), NLR (p=0.003) and PLR (p=0.007) correlated significantly with overall survival. However, there was no significant correlation of age, leukocyte, lymphocyte and platelet counts and hemoglobin values with overall survival of patients. Furthermore, the same tests showed that leukocyte (p=0.04), neutrophil (p=0.0014) and platelet (p=0.006) counts, NLR (p=0.0006) and PLR (p=0.0015), as well as hemoglobin values (p=0.028) correlated significantly with disease-free survival. The results of univariate analysis showed that unlike PLR, NLR correlated with overall survival and disease-free survival (p=0.0002), although the correlation of PLR and disease-free survival almost reached significance (p=0.059). Furthermore, the results of univariate analysis showed significant correlation of advanced pathological TNM stage with overall survival. There was no correlation of patient age and gender, tumor stage and neoadjuvant chemo-radiotherapy with overall survival and disease-free survival. The results of multivariate analysis showed that NLR (cut-off value 3.27) and advanced pathological TNM stage significantly correlated with disease-free survival but not with overall survival. It seems that NLR might be an accurate marker for overall survival and disease-free survival in CRC patients after neoadjuvant chemo-radiotherapy and before surgery.

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Section: Discussionmentioning

confidence: 99%

The Role of Complete Blood Count Parameters in Patients with Colorectal Cancer

Mekić

Pedišić

Šobat

et al. 2018

ACC

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“…Red blood cells, the most important oxygen-carrying medium in the body, will induce hypoxia or a hypoxic microenvironment when they differ in size or their functions are impaired. This microenvironment may accelerate the formation of tumor neovascularization by stimulating the production of vascular endothelial growth factor (VEGF) in the body [27]. Hypoxia or a hypoxic microenvironment can also induce the expression of the hypoxia-inducible factor (HIF) family, which may lead to tumor progression, cancer aggravation or poor prognosis [28].…”

Section: Plos Onementioning

confidence: 99%

The value of red blood cell distribution width, neutrophil-to-lymphocyte ratio, and hemoglobin-to-red blood cell distribution width ratio in the progression of non-small cell lung cancer

Chen

et al. 2020

PLoS ONE

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Background Lung cancer is the leading cause of cancer-related deaths worldwide, with non-small cell lung cancer (NSCLC) accounting for 85% of all lung cancer cases. Inflammation has been proven to be one of the characteristics of malignant tumors. Chronic inflammatory response mediated by cytokines in the tumor microenvironment is an important factor in tumorigenesis. The purpose of this study was to observe and evaluate the value of red blood cell distribution width (RDW), neutrophil-to-lymphocyte ratio (NLR), and hemoglobin-to-red blood cell distribution width ratio (HRR) in the progression of NSCLC. Methods A total of 245 patients with NSCLC, 97 patients with benign pulmonary nodules, and 94 healthy volunteers were included in this study. Factors, such as age, gender, smoking history, histological type, lymph node metastasis, distant metastasis, TNM stage, and differentiation degree were statistically analyzed. The correlation of RDW, NLR, and HRR of patients with NSCLC with other clinical experimental parameters were also analyzed. Then, the diagnostic value of RDW, NLR, and HRR in the progression of NSCLC was evaluated. Results RDW, NLR, and HRR could be used to distinguish patients with NSCLC from healthy controls (p < 0.05). In addition, only the RDW in the NSCLC group with III-IV stage was significantly different from that in the benign pulmonary nodules group (p = 0.033), while NLR and

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“…Wei also reported that Hb changes after adjuvant chemotherapy is related to the prognosis of CRC patients [17]. The point is stage II and III patients are all confounded in that study and receive FOLFOX regimen treatment, while IDEAL study suggests only stage II CRC patients with high risks are recommended to be adjuvantly treated.…”

Section: Discussionmentioning

confidence: 90%

“…Yang [5] found that red blood cell distribution width was closely related to colorectal cancer metastasis. Wei [6] reported that chemotherapy-associated hemoglobin might be a prognostic bio-marker. Zhang [7] claimed that elevated red blood cell volume distribution width-the change of diversity (RDW-CV) might be an independent predictive factor in resectable rectal cancer patients.…”

Section: Introductionmentioning

confidence: 99%

Can red cell distribution width and hemoglobin level variations be utilized to predict the prognosis of Stage III operative colorectal cancer patients with adjuvant chemotherapy treatment?

Song

Zhang

et al. 2020

Preprint

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Background: The aim of this study was to find that if the red cell distribution width (RDW) or hemoglobin (Hb) level variations had prognostic value in stage III colorectal cancer patients treated with operation and adjuvant chemotherapy. Methods: One hundred and twenty-two patients were included in this retrospective study. All were diagnosed and re-staged as stage III colorectal cancer in Sichuan Cancer Hospital according to the AJCC Cancer Staging Manual, 8 th edition, 2018. The patients received R0 resection before adjuvant chemotherapy. The baseline information, routine blood examination data, pathological outcome and prognostic stature was retracted from the database. Receiver operating characteristic (ROC) curve analysis was utilized to determine the cut-off value, while the survival analyses were performed with Kaplan-Meier curve, the log-rank test and the Cox regression analysis. Results: The chemotherapy-associated hemoglobin change (change between the pre- and post-chemotherapy hemoglobin levels) was identified to be associated with the metastasis (P=0.030). The optimal cut-off point was calculated to be -9.5 by the ROC curve of the hemoglobin change, while the area under the curve was 0.648 (95% CI: 0.524-0.772). The results showed that patients with larger hemoglobin decrease had significantly worse disease free survival (DFS) than those with smaller decrease (P=0.020). Factors associated with DFS in uni-variate COX regression analysis were the number of harvested lymph nodes (P=0.040) and the perineural invasion (P=0.020). The peri-chemotherapy change of hemoglobin level was estimated to have significant effect on patient survival (P=0.010). Conclusions: We concluded that chemotherapy-associated Hb change (change between the pre- and post-chemotherapy) was a DFS prognostic factor for the stage III colorectal cancer patients who underwent operation and adjuvant chemotherapy.

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The impact of chemotherapy-associated hemoglobin on prognosis of colorectal cancer patients receiving adjuvant chemotherapy

Abstract: Chemotherapy-associated hemoglobin < 90 g/L has a significant prognostic value in CRC receiving adjuvant chemotherapy, which is a significant biomarker in the individualized management and may suggest the simple indication for the treatment of anemia in adjuvant chemotherapy in CRC.

Cited by 13 publications

References 31 publications

The Role of Complete Blood Count Parameters in Patients with Colorectal Cancer

The Role of Complete Blood Count Parameters in Patients with Colorectal Cancer

The value of red blood cell distribution width, neutrophil-to-lymphocyte ratio, and hemoglobin-to-red blood cell distribution width ratio in the progression of non-small cell lung cancer

Can red cell distribution width and hemoglobin level variations be utilized to predict the prognosis of Stage III operative colorectal cancer patients with adjuvant chemotherapy treatment?

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