Shahid Gilani, MD from University Hospital Of North Midlands speaks about the Impact of haemoglobin level and blood transfusion on survival outcome of gastric cancer patients – A single institute experience.
In several solid tumours, anaemia is a common complication that often occurs in gastric cancer. Hemoglobin ( Hb) was less than 100g / L in about 41 percent of patients with advanced gastric cancer. Multi-factorial factors. Studies have shown this to be an independent factor in the outcome of survival for different cancers, but few have focused on gastric cancer. RBC transfusion is always recommended, but whether it has a survival advantage is less evident. In gastric cancer patients, we aimed to classify initial and nadir Hb and to recognize its effect on their overall survival (OS).
A retrospective analysis at the University Hospital of North Midlands, UK, for 112 patients from 2013 to 2020. Profiles of patients and clinical data were examined for survival outcomes in relation to different variables, including Hb level. Analysis of univariate, multivariate, and Kaplan-Meier survival was performed.
112 patients, with a median age of 73 years, including 79 males (70%), most of whom had stage III and stage IV diseases. Out of 112 patients (78 percent), a total of 88 did not undergo surgery because of inoperable cancers. The vast majority of patients (85%) received anaemia-enhancing RBC transfusions. The majority of patients received chemotherapy with EOX or ECX (93 percent). Survival: 98 (87.5 percent) out of 112 patients died. The median OS calculation was 12 months (SD=17). The 1, 3, and 5 years of OS were 55%, 30%, and 10% respectively. The median progression-free survival (PFS) was 18 months (SD=20) with any therapy. Higher Hb (> 100 g / L) patients fared better than lower Hb (< 80 g / L) patients. The statistical significance of the Hb level and resection method for OS (P=0.0122 and P=0.0001) was shown by univariate analysis. As independent variables of the outcome, multivariate analysis demonstrated point, surgical resection, and Hb level.
The point in the prevalence of anaemia during treatment in our patients with gastric cancer had an effect on overall survival. With the transfusion of RBC, the result could not be changed. Our results demonstrate the need for a clear diagnostic and therapeutic approach to anaemia in this area.
Declaration of Effects
In gastric cancer, low Hb levels are correlated with poor outcomes, irrespective of blood transfusion may be associated with a lying immune mechanism calling for future research aimed at the response of the immune system to increasing cancer.