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Preoperative anemia predicts poor outcome in surgically resected early-stage NSCLC patients

Yovino S et al. (2005) An association between preoperative anemia and decreased survival in earlystage non-small-cell lung cancer patients treated with surgery alone. Int J Radiat Oncol Biol Phys 62: 1438–1443

A recently published retrospective analysis by a group at the University of Maryland School of Medicine has shown that preoperative anemia is a significant prognostic factor in patients with early-stage non-small-cell lung cancer (NSCLC) treated with surgery alone.

Relapse-free survival (RFS) and overall survival (OS) were calculated for 82 patients who had undergone surgical resection for stage I (n = 72) or II (n = 10) NSCLC. The 2-year RFS and OS for the entire cohort were 66% and 76.3%, respectively. Preoperative hemoglobin (Hb) level was the only factor found to significantly influence outcome in both the univariate and multivariate analyses, although there was a nonsignificant trend toward reduced survival in p53-negative patients. Multivariate analysis revealed that patients with preoperative Hb levels <12 mg/dl had significantly worse RFS and OS than those with Hb levels ≥12 mg/dl (P = 0.020 and P = 0.026, respectively).

The authors conclude that preoperative anemia is associated with increased risk of treatment failure and reduced survival, even in patients with traditionally low-risk, early-stage NSCLC. They suggest that anemia might be an indication of a more aggressive tumor and advocate further research into the prospect of using adjuvant therapy in these patients.


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King, A. Preoperative anemia predicts poor outcome in surgically resected early-stage NSCLC patients. Nat Rev Clin Oncol 2, 489 (2005).

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