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. 2014 Nov 18:14:844.
doi: 10.1186/1471-2407-14-844.

Impact of preoperative anemia on relapse and survival in breast cancer patients

YingJun Zhang, YuYang Chen, DongTai Chen, Yu Jiang, Wan Huang, HanDong Ouyang, Wei Xing, MuSheng Zeng, XiaoMing Xie, Weian Zeng  1
Affiliations

Impact of preoperative anemia on relapse and survival in breast cancer patients

YingJun Zhang et al. BMC Cancer. .

Abstract

Background: Previous studies have shown that preoperative anemia is correlated with the prognoses of various solid tumors. This study was performed to determine the effect of preoperative anemia on relapse and survival in patients with breast cancer.

Methods: A total of 2960 patients with breast cancer who underwent surgery between 2002 and 2008 at the Sun Yat-sen University Cancer Center (Guangzhou, PR China) were evaluated in a retrospective analysis. A total of 2123 qualified patients were divided into an anemic group [hemoglobin (Hb) < 12.0 g/dL, N = 535)] and a nonanemic group (Hb ≥ 12.0 g/dL, N = 1588). The effects of anemia on local relapse-free survival (LRFS), lymph node metastasis-free survival (LNMFS), distant metastasis-free survival (DMFS), relapse-free survival (RFS), and overall survival (OS) were assessed using Kaplan-Meier analysis. Independent prognostic factors were identified in the final multivariate Cox proportional hazards regression model.

Results: Among the 2123 women who qualified for the analysis, 535 (25.2%) had a Hb level < 12.0 g/dL. The Kaplan-Meier curves showed that anemic patients had worse LRFS, LNMFS, DMFS, RFS, and OS than nonanemic patients, even in the same clinical stage of breast cancer. Cox proportional hazards regression model indicated that preoperative anemia was an independent prognostic factor of LRFS, LNMFS, DMFS, RFS, and OS for patients with breast cancer.

Conclusions: Preoperative anemia was independently associated with poor prognosis of patients with breast cancer.

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Figures

Figure 1
Figure 1
Flow chart of the patient grouping.
Figure 2
Figure 2
LRFS, LNMFS, DMFS, RFS, and OS of patients with and without anemia. A. LRFS for patients with Hb ≥ 12 g/dL versus Hb < 12 g/dL. B. LNMFS for patients with Hb ≥12 g/dL versus Hb <12 g/dL. C. DMFS for patients with Hb ≥12 g/dL versus Hb <12 g/dL. D. RFS for patients with Hb ≥12 g/dL versus Hb <12 g/dL. E. OS for patients with Hb ≥12 g/dL versus Hb <12 g/dL.
Figure 3
Figure 3
LRFS, LNMFS, DMFS, RFS, and OS of patients in stage I with and without anemia. A. LRFS for patients with Hb ≥12 g/dL versus Hb <12 g/dL in stage I. B. LNMFS for patients with Hb ≥12 g/dL versus Hb <12 g/dL in stage I. C. DMFS for patients with Hb ≥12 g/dL versus Hb <12 g/dL in stage I. D. RFS for patients with Hb ≥12 g/dL versus Hb <12 g/dL in stage I. E. OS for patients with Hb ≥12 g/dL versus Hb <12 g/dL in stage I.
Figure 4
Figure 4
LRFS, LNMFS, DMFS, RFS, and OS for patients in stage II with and without anemia. A. LRFS for patients with Hb ≥12 g/dL versus Hb <12 g/dL in stage II. B. LNMFS for patients with Hb ≥12 g/dL versus Hb <12 g/dL in stage II. C. DMFS for patients with Hb ≥12 g/dL versus Hb <12 g/dL in stage II. D. RFS for patients with Hb ≥12 g/dL versus Hb <12 g/dL in stage II. E. OS for patients with Hb ≥12 g/dL versus Hb <12 g/dL in stage II.
Figure 5
Figure 5
LRFS, LNMFS, DMFS, RFS, and OS for patients in stage III with and without anemia. A. LRFS for patients with Hb ≥12 g/dL versus Hb <12 g/dL in stage III. B. LNMFS for patients with Hb ≥12 g/dL versus Hb <12 g/dL in stage III. C. DMFS for patients with Hb ≥12 g/dL versus Hb <12 g/dL in stage III. D. RFS for patients with Hb ≥12 g/dL versus Hb <12 g/dL in stage III. E. OS for patients with Hb ≥12 g/dL versus Hb <12 g/dL in stage III.
Figure 6
Figure 6
LRFS, LNMFS, DMFS, RFS, and OS for patients without anemia versus mild anemia. A. LRFS for patients with Hb ≥12 g/dL versus 9 < Hb <12 g/dL. B. LNMFS for patients with Hb ≥12 g/dL versus 9 < Hb <12 g/dL. C. DMFS for patients with Hb ≥12 g/dL versus 9 < Hb <12 g/dL. D. RFS for patients with Hb ≥12 g/dL versus 9 < Hb <12 g/dL. E. OS for patients with Hb ≥12 g/dL versus 9 < Hb <12 g/dL.
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Pre-publication history
    1. The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1471-2407/14/844/prepub

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