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. 2018 Dec;34(6):312-316.
doi: 10.3393/ac.2017.10.12. Epub 2018 Dec 31.

Chemotherapeutic Response and Survival for Patients With an Anal Squamous Cell Carcinoma and Low Hemoglobin Levels

A Naqvi  1 , E Platt  1 , M Jitsumura  2 , M Evans  2 , M Coleman  1 , S Smolarek  1
Affiliations

Chemotherapeutic Response and Survival for Patients With an Anal Squamous Cell Carcinoma and Low Hemoglobin Levels

A Naqvi et al. Ann Coloproctol. 2018 Dec.

Abstract

Purpose: Anemia is associated with poor treatment results for a variety of cancers. The effect of low hemoglobin levels on long-term outcomes after the treatment of patients with an anal squamous cell carcinoma (SCC) remains unclear. For that reason, this study aimed to investigate the effect of anemia on treatment outcomes following chemoradiation for an anal SCC.

Methods: This was a retrospective study of all patients who underwent curative treatment for an anal SCC between 2009 and 2015 at 2 trusts in the United Kingdom. Data were collated from prospectively collected cancer databases and were cross-checked with operating-room records and records in the hospitals' patient management systems.

Results: We identified 103 patients with a median age of 63 years (range, 36-84 years). The median overall survival was 39 months (range, 9-90 months), and the disease-free survival was 36 months (range, 2-90 months). During the follow-up period, 16.5% patients died and 13.6% patients developed recurrence. Twenty-two people were anemic prior to treatment, with a female preponderance (20 of 22). No differences in disease-free survival (P = 0.74) and overall survival (P = 0.12) were noted between patients with anemia and those with normal hemoglobin levels. On regression the analysis, the combination of anemia, the presence of a defunctioning colostomy, lymph-node involvement and higher tumor stage correlated with poor overall survival.

Conclusion: In this study, anemia did not influence disease-free survival or overall survival. We suggest that the interaction between anemia and survival is more complex than previously demonstrated and potentially reliant on other coexisting factors.

Keywords: Anal squamous cell carcinoma; Anemia; Chemotherapy; Hemoglobin; Survival.

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Conflict of interest statement

No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1.
Fig. 1.
Flow chart of the study. Hb, hemoglobin.
Fig. 2.
Fig. 2.
Kaplan-Mayer curve showing the percent of patients surviving at a given time (overall survival) in relation to the presence or absence of anemia. NHB, normal hemoglobin level; LHB, low hemoglobin level.
Fig. 3.
Fig. 3.
Percent of patients surviving at a given time (overall survival) in relation to the presence or absence of a defunctioning stoma.
Fig. 4.
Fig. 4.
Percent of patients surviving at a given time (overall survival) in relation to the presence or absence of lymph-node involvement.
See this image and copyright information in PMC

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