Multicenter cross-sectional study of anemia in patients with gastric and colorectal cancer before and after the operation / 中华外科杂志

<p><b>OBJECTIVES</b>To determine the prevalence of cancer-related anemia and iron deficiency anemia (IDA) in patients with gastric and colorectal cancer in North of China.</p><p><b>METHODS</b>A cross-sectional study of 262 inpatients diagnosed with gastric or colorectal cancer admitted to eight general hospitals in Beijing from August 2009 to December 2009 was performed. The blood samples were took on the day after admission and the seventh day after operation for the tests of hemoglobin, serum iron and ferritin. The morbidity of cancer-related anemia and IDA before and after the surgery was also compared respectively.</p><p><b>RESULTS</b>The preoperative morbidity of cancer-related anemia was 36.6% in 131 patients with gastric cancer, and the morbidity of IDA was 52.1%. The mean age of the anemic patients was higher than that in cases without anemia [(62 ± 11) yrs vs. (57 ± 12) yrs, P < 0.05]; the postoperative morbidity of IDA increased to 72.6% (P < 0.05). In the 131 cases with colorectal cancer, the preoperative incidence of cancer-related anemia and IDA was 37.4% and 61.2%, respectively. About 45% of the cases with anemia had a tumor in the right colon. Postoperative incidence of IDA was significantly higher than that before the surgery (76.7%, P < 0.05). Only 10.3% of the anemic patients were treated with chalybeate therapy before surgical procedures, and the proportion was 22.7% after the operation. More than 50% of anemic patient received blood transfusion.</p><p><b>CONCLUSIONS</b>Cancer-related anemia is a common clinical manifestation in patients with gastrointestinal cancer, and anemia occurs more frequently in elder and patients with right colon tumor. The treatment to cancer-related anemia is insufficient and a systematic therapy is needed to be established.</p>

Comprehensive analysis of relevant factors on colorectal cancer-related anemia / 中国医学科学院学报

<p><b>OBJECTIVE</b>To analyze the risk factors of colorectal cancer-related anemia.</p><p><b>METHOD</b>The clinical data of 319 patients with colorectal cancer were retrospectively analyzed for the possible risk factors of tumor-related anemia including tumor location, clinical stage, clinical symptoms, pathology, gender, and age.</p><p><b>RESULTS</b>Of these 319 cases, 141 (44.20%) had anemia. The incidence of anemia was 62.20% among patients with right hemicolon cancers (including caecum cancer), and was 23.82% among patients with rectal cancer and 36.23% among those with transverse descending or sigmoid colon cancer. Cardia insufficiency, melena, tumor location, T staging, hypoproteinemia were also found to be related with anemia. Anemia and hypoproteinemia were the risk factors for perioperative blood transfusion (odds ratio = 3.004, odds ratio = 8.356, respectively).</p><p><b>CONCLUSIONS</b>The colorectal cancer-related anemia is not associated with the clinical stage of the tumor, while cardiac insufficiency, melena, tumor location, tumor stage, and hypoproteinemia constitute the possible risk factors. Anemia and hypoproteinemia are the risk factors of perioperative blood transfusion.</p>

Investigation of tumor related anemia in 10,218 patients with cancer in the digestive system / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To study the prevalence of tumor related anemia in patients with cancer in the digestive system.</p><p><b>METHODS</b>A total of of 10 218 inpatients were diagnosed with cancer in the digestive system at the Peking Union Hospital from January 2000 to June 2009, which included esophageal cancer(n=1118), gastric cancer(n=2418), carcinoma of duodenum(n=134), carcinoma of small intestine(n=85), hepatocellular cancer(n=1508), cholangiocarcinoma(n=546), pancreatic cancer (n=1242), colon cancer(n=1582), and rectal cancer(n=1585). Patients with hemolytic anemia or hepatorenal dysfunction were excluded. Data pertaining to sex, age and hemoglobin were obtained by chart review.</p><p><b>RESULTS</b>According to the China criteria of anemia, the overall anemia rate was 27.5% (2813/10 218). The prevalence of anemia was 64.7% for small bowel cancer, 60.5% for duodenal cancer, 42.6% for colon cancer, 36.6% for cholangiocarcinoma, 33.3% for gastric cancer, 22.6% for pancreatic cancer, 20.4% for rectal cancer, 18.7% for hepatocellular cancer, and 10.0% for esophageal cancer. Anemia was more common in older patients in those with gastric cancer, cholangiocarcinoma, pancreatic cancer, colon cancer and rectal cancer. There were more male anemic patients in those with cancer in the small intestine or cholangiocarcinoma. However, females were more commonly seen in those with hepatocellular cancer or pancreatic cancer.</p><p><b>CONCLUSIONS</b>Anemia is common in patients with cancer in the digestive system. The prevalence of anemia is higher in patients with cancer in the duodenum carcinoma or small intestine, followed by colon cancer and gastric cancer, and then esophageal cancer. Anemia may be associated with age or gender in some types of cancer in the digestive system.</p>