Importance of anemia in colorectal cancer

  • Adriana Della Valle Universidad de la República, Facultad de Medicina, Hospital de Clínicas, Oncología Médica, Residente. Grupo Colaborativo Uruguayo: Investigación de Afecciones Oncológicas Hereditarias, Miembro. Hospital Central de las Fuerzas Armadas
  • Carlos Sarroca Grupo Colaborativo Uruguayo: Investigación de Afecciones Oncológicas Hereditarias, Director. Hospital Central de las Fuerzas Armadas, Cirujano
Keywords: COLORECTAL NEOPLASMS, ANEMIA, FORECAST

Abstract

Colorectal cancer is the second cause of cancer mortality in Uruguay accounting for 23.61% out of the total death for cancer. Anemia, a frequent symptom in patients with colorectal cancer, is associated with shorter life-time but its prognostic value is questionned.
The aim of the paper is to determine the role of anemia before surgery in patients with colorectal cancer in the prognosis.
A retrospective follow up study of 411 patients with colorectal cancer from 1987 to 2002. Anemia before surgery was seen in 230 patients (56%): injuries were predominant in right colon (84/230, 36.5%), mean age was 68 years. Anemia was not observed in 181 patients: injuries were predominant at rectal level (73/181, 40.3%), mean age was 64 years. Global and surgical mortality were higher in patients with anemia: 47% versus 34% p=0.05, and 10% versus 3% p=0.009. Dukes stages B, C and D were predominant (394/411, 96%).
Anemia before surgery in patients with colorectal cancer has negative incidence in prognosis, and increases global and surgical mortality rates.

References

1) Organización Panamericana de la Salud. Las Condiciones de Salud en las Américas: volumen II. Washington: OPS, 1994: 466-77.
2) Vasallo JA, Barrios E. Cáncer Colorrectal. In: II Atlas de mortalidad por cáncer en el Uruguay. Montevideo: Comisión Honoraria de Lucha contra el Cáncer, 1999: 20-1.
3) Kemppainen M, Raiha I, Rajala T, Sourander L. Delay in diagnosis of colorectal cancer in elderly patients. Age Ageing 1993; 22(4): 260-4.
4) Dunne Jr, Gannon Cj, Osborn Tm, Taylor Md, Malone Dl, Napolitano Lm. Preoperative anemia in colon cancer: assessment of risk factors. Am Surg 2002; 68(6): 582-7.
5) Sadahiro S, Suzuki T, Tokunaga N, Mukai M, Tajima T, Makuuchi H, et al. Anemia in patients with colorectal cancer. J Gastroenterol 1998; 33(4): 488-94.
6) Tan Ym, Rosmawati M, Ranjeev P, Goh KL. Predictive factors by multivariate analysis for colorectal cancer in Malaysian patients undergoing colonoscopy. J Gastroenterol Hepatol 2002; 17(3): 281-4.
7) Diculescu M, Iacob R, Iacob S, Croitoru A, Becheanu G, Popeneciu V. The importance of histopathological and clinical variables in predicting the evolution of colon cancer. Rom J Gastroenterol 2002; 11(3): 183-9.
8) Dunne Jr, Malone D, Tracy Jk, Gannon C, Napolitano Lm. Perioperative anemia: an independent risk factor for infection, mortality, and resource utilization in surgery. J Surg Res 2002; 102(2): 237-44.
9) Kishida T, Sato J, Fujimori S, Minami S, Yamakado S, Tamagawa Y, et al. Clinical significance of serum iron and ferritin in patients with colorectal cancer. J Gastroenterol 1994; 29(1): 19-23.
10) Arnoux R, Corman J, Peloquin A, Smeesters C, St-Louis G. Adverse effect of blood transfusions on patient survival after resection of rectal cancer. Can J Surg 1988; 31(2): 121-6.
11) Sibbering Dm, Locker Ap, Hardcastle Jd, Armitage NC. Blood transfusion and survival in colorectal cancer. Dis Colon Rectum 1994; 37(4): 358-63.
12) Celestino A, Castillo T, Frisancho O, Contardo C, Espejo H, Tomioka C, et al. Colorectal cancer: study on 365 cases. Rev Gastroenterol Perú 1996; 16(3): 187-96.
13) Bioinformación Latino América. Hemograma. www.bioinformacion.net [consulta: 01/06/2003].
14) Rubiano J, Mariño G, Kestenberg A. Guías de Práctica Clínica basada en la Evidencia: tamizaje en Cáncer Digestivo. Santafé de Bogotá: ASCOFAME-ISS 1998: 30-4.
15) Astler Vb, Coller FA. The prognostic significance of direct extension of carcinoma of the colon and rectum. Ann Surg 1954; 139(6): 846-52.
16) Prelipcean Cc, Mihai C, Stanciu C. The examination of the digestive tract in patients with iron-deficiency anemia. Rev Med Chir Soc Med Nat Iasi 2000; 104(4): 51-3.
17) Ayyub Mi, Al-Radi Ao, Khazeindar Am, Nagi Ah, Maniyar IA. Clinicopathological trends in colorectal cancer in a tertiary care hospital. Saudi Med J 2002; 23(2): 160-3.
18) Harris GJ, Simson JN. Causes of late diagnosis in cases of colorectal cancer seen in a district general hospital over a 2-year period. Ann R Coll Surg Engl 1998; 80(4): 246-8.
Published
2004-08-31
How to Cite
1.
Della Valle A, Sarroca C. Importance of anemia in colorectal cancer. Rev. Méd. Urug. [Internet]. 2004Aug.31 [cited 2024Dec.18];20(2):114-9. Available from: https://www2.rmu.org.uy/ojsrmu311/index.php/rmu/article/view/916