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

Article type: Research Article

Authors: Wei, Yi-Sheng^{a; b} | Zhou, Ya-Guang^a | Wang, Guo-Ying^{c; *; 1} | Liang, Zhi-Hua^a | Luo, Min-Rui^a | Yang, Tian-Ai^d | Huang, Jun^{e; *; 1}

Affiliations: [a] Department of Gastrointestinal Surgery, Lab of Surgery, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou 510260, Guangdong, China | [b] Sino-French Hoffmann Institute, Guangzhou Medical University, Guangzhou 511436, Guangdong, China | [c] Department of Hepatic Surgery and Liver Transplantation Center, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou 510630, Guangdong, China | [d] Department of General Surgery, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou 510260, Guangdong, China | [e] Department of Gastrointestinal Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi, China

Correspondence: [*] Corresponding authors: Guo-Ying Wang , Department of Hepatic Surgery and Liver transplantation Center, The Third Affiliated Hospital, Sun Yat-sen University, 600 Tianhe Road, Guangzhou 510630, Guangdong, China. Tel.: +86 020 85252177; Fax: +86 020 85252276; Email: wanggy3@126.com. Jun Huang, Department of Gastrointestinal Surgery, The Second Affiliated Hospital of Nanchang University, 1 Min-de Road, Nanchang 330006, Jiangxi, China. Tel.: +86 0791 86312056; Fax: +86 0791 86848045; E-mail: huangjun20070901@163.com.

Note: [1] Authors who made equal contributions.

Abstract: BACKGROUND AND OBJECTIVE: The association of chemotherapy-associated hemoglobin and survival of colorectal cancer (CRC) receiving adjuvant chemotherapy is uncertain. We sought to explore the prognostic value of chemotherapy-associated hemoglobin in CRC receiving adjuvant chemotherapy and the best cut point affecting prognosis. METHODS: Three hundred and twenty stage II and III CRC patients receiving adjuvant FOLFOX chemotherapy from March 2003 to March 2012 were enrolled. The associations between chemotherapy-associated hemoglobin (the absolute levels of post-chemotherapy) or chemotherapy-associated hemoglobin change (change between the pre- and post-chemotherapy hemoglobins) and disease free survival (DFS) or overall survival (OS) of CRC, and the best cut point were investigated. RESULTS:Log rank test showed the best cut points for chemotherapy-associated hemoglobin and chemotherapy-associated hemoglobin change were respectively 90 g/L, 30 g/L. Cox regression model showed chemotherapy-associated hemoglobin < 90 g/L was the independent prognostic factor for DFS (HR, 2.221; 95% CI = 1.157–4.262), OS (HR, 2.058; 95% CI = 1.009–4.197), respectively, but no association of chemotherapy-associated hemoglobin change ⩾ 30g/L and DFS (HR, 2.063; 95% CI = 0.929–4.583), OS (HR, 1.386; 95% CI = 0.553–3.471) was found. CONCLUSIONS: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.

Keywords: Adjuvant chemotherapy, colorectal cancer, hemoglobin, disease free survival, overall survival

DOI: 10.3233/CBM-170601

Journal: Cancer Biomarkers, vol. 20, no. 4, pp. 627-635, 2017