Mide Kanseri Ve Preoperatif Anemi Arasındaki İlişkinin Değerlendirilmesi

Year 2021, Volume: 18 Issue: 2, 240 - 245, 27.08.2021

Murat Can Mollaoğlu , Meriç Bostancı , Kürşat Karadayı

https://doi.org/10.35440/hutfd.897403

Abstract

Giriş Amaç: Kanser hastalarının preoperatif en sık görülen klinik problemlerinden biri preoperatif anemidir. Preoperatif aneminin en sık görüldüğü kanser türlerinden biri mide kanseridir. Fakat, mide kanserinin anemi ile ilişkisi net değildir. Bu çalışmanın amacı mide kanserli hastaların bağımsız prognostik risk faktör olan patolojik evrelerinin ve tümör boyutlarının ameliyat öncesi hemoglobin değerleriyle karşılaştırarak preoperatif anemi ile tümör boyutu ve tümör evresi arasındaki ilişkiyi incelemek ve prognostik belirteçleri zayıf olan mide kanseri için preoperatif aneminin prognostik değerini araştırmaktır.
Materyal ve Metod : XX üniversitesi XX bölümünde 1 ocak 2017 ile 1 aralık 2019 yılları arasında mide kanseri dolayısıyla küratif D2 gastrektomi ve Ro rezeksiyon uygulanmış hastaların klinikopatolojik ve demografik özellikleri retrospektif olarak incelendi.
Bulgular : Toplam 85 hasta incelendi. Hastaların 66 (%77,6)’sı erkek 19 (%22,4)’u kadındı. Hastaların yaş ortalaması 68,1(41-87) idi. 55(%64,7) hastaya total gastrektomi 30 (%35,2) hastaya subtotal gastrektomi uygulandı. Hastaların tümü adenokarsinom tanılı idi. Hastaların 48(%56,5)’i evre 3, 29(%34,1)’u evre 2, 8(%9,4)’i evre 1 idi. 51(%60) hastanın tümör boyutu büyük 34(%40) hastanın küçüktü.51(%60) hastanın anemisi vardı.
Sonuç : Preoperatif anemisi bulunan mide kanserli hastaların tümör boyutları daha büyük ve ileri evre tümörlerdir. Mide kanserli hastaların tedavisi planlanırken preoperatif anemisi bulunan hastaların tümör özelliklerinin daha agresif olabileceği gözardı edilmememidir.

Keywords

preoperatif anemi, mide kanseri, hemoglobin

Evaluation Of The Relationship Between Stomach Cancer and Preoperative Anemia

Abstract

Background: One of the most common preoperative clinical problems of cancer patients is preoperative anemia and one of the most common types of cancer with preoperative anemia is stomach cancer. However, the relationship between stomach cancer and anemia is not clear. The aim of this study is to examine the relationship between preoperative anemia and tumor size and tumor stage by comparing the pathological stages and tumor sizes, which are independent prognostic risk factors, with preoperative hemoglobin values, and to investigate the prognostic value of preoperative anemia for gastric cancer with poor prognostic markers.
Materials and Methods: The clinicopathological and demographic characteristics of patients who underwent curative D2 gastrectomy and R0 resection due to gastric cancer between January 1, 2017 and December 1, 2019 in Cumhuriyet University Department of Surgical Oncology were retrospectively analyzed.
Results : A total of 85 patients were examined. 66 (77.6%) of the patients were male and 19 (22.4%) were female. Total gastrectomy was performed in 55 (64.7%) patients and 30 (35.2%) patients underwent subtotal gastrectomy. All patients were diagnosed with adenocarcinoma. 48 (56.5%) of the patients were stage 3, 29 (34.1%) were stage 2, 8 (9.4%) were stage 1. Tumor size of 51 (60%) patients was large and 34 (40%) patients were small. 51 (60%) patients had anemia.
Conclusion : The tumor size of gastric cancer patients with preoperative anemia is larger and their tumors are advanced. When planning the treatment of patients with gastric cancer, it should not be overlooked that patients with preoperative anemia may have more aggressive tumor characteristics.

Keywords

preoperative anemia, stomach cancer, hemoglobin

References

• Referans1 Siegel RL, Miller KD, Jemal A. Cancer statistics, 2019. CA: a cancer journal for clinicians. 2019;69(1):7-34.
• Referans 2 Das M. Neoadjuvant chemotherapy: survival benefit in gastric cancer. The Lancet Oncology. 2017;18(6):e307.
• Referans 3 Lv X, Zhang L, Huang R, Song W. A clinical exploration of neoadjuvant chemotherapy with tegafur, gimeracil, and oteracil potassium capsules combined with oxaliplatin for advanced gastric cancer. International journal of clinical and experimental medicine. 2015;8(10):19030.
• Referans 4 Zhang X-y, Zhang P-y. Gastric cancer: somatic genetics as a guide to therapy. Journal of Medical Genetics. 2017;54(5):305-12.
• Referans 5 Lordick F, Kang Y-K, Chung H-C, Salman P, Oh SC, Bodoky G, et al. Capecitabine and cisplatin with or without cetuximab for patients with previously untreated advanced gastric cancer (EXPAND): a randomised, open-label phase 3 trial. The lancet oncology. 2013;14(6):490-9.
• Referans 6 Waddell T, Chau I, Cunningham D, Gonzalez D, Okines AFC, Wotherspoon A, et al. Epirubicin, oxaliplatin, and capecitabine with or without panitumumab for patients with previously untreated advanced oesophagogastric cancer (REAL3): a randomised, open-label phase 3 trial. The lancet oncology. 2013;14(6):481-9.
• Referans 7 Blakely AM, Miner TJ. Surgical considerations in the treatment of gastric cancer. Gastroenterology Clinics. 2013;42(2):337-57.
• Referans 8 Tan VP, Wong BC. Gastric cancer chemoprevention: the current evidence. Gastroenterology Clinics. 2013;42(2):299-316.
• Referans 9 Iorio MV, Croce CM. MicroRNA dysregulation in cancer: diagnostics, monitoring and therapeutics. A comprehensive review. EMBO molecular medicine. 2012;4(3):143-59.
• Referans 10 Hartgrink HH, Jansen EP, van Grieken NC, van de Velde CJ. Gastric cancer. The Lancet. 2009;374(9688):477-90.
• Referans 11 Roukos DH, Kappas AM. Perspectives in the treatment of gastric cancer. Nature Clinical Practice Oncology. 2005;2(2):98-107.
• Referans 12 Shiozaki H, Shimodaira Y, Elimova E, Wadhwa R, Sudo K, Harada K, et al. Evolution of gastric surgery techniques and outcomes. Chinese journal of cancer. 2016;35(1):69.
• Referans 13 Edge SB, Compton CC. The American Joint Committee on Cancer: the 7th edition of the AJCC cancer staging manual and the future of TNM. Annals of surgical oncology. 2010;17(6):1471-4.
• Referans 14 Hosoda K, Yamashita K, Katada N, Moriya H, Mieno H, Sakuramoto S, et al. Preoperative tumor size is a critical prognostic factor for patients with Borrmann type III gastric cancer. Surgery today. 2015;45(1):68-77.
• Referans 15 Im WJ, Kim MG, Ha TK, Kwon SJ. Tumor size as a prognostic factor in gastric cancer patient. Journal of gastric cancer. 2012;12(3):164-72.
• Referans 16 Quan J, Zhang R, Liang H, Li F, Liu H, Zhang H, et al. The impact of tumor size on survival of patients with pT4aN0M0 gastric cancer. The American Surgeon. 2013;79(3):328.
• Referans 17 Zhao L-Y, Chen X-L, Wang Y-G, Xin Y, Zhang W-H, Wang Y-S, et al. A new predictive model combined of tumor size, lymph nodes count and lymphovascular invasion for survival prognosis in patients with lymph node-negative gastric cancer. Oncotarget. 2016;7(44):72300.
• Referans 18 Zu H, Wang F, Ma Y, Xue Y. Stage-stratified analysis of prognostic significance of tumor size in patients with gastric cancer. PloS one. 2013;8(1):e54502.
• Referans 19 Knight K, Wade S, Balducci L. Prevalence and outcomes of anemia in cancer: a systematic review of the literature. The American journal of medicine. 2004;116(7):11-26.
• Referans 20 Tas F, Eralp Y, Basaran M, Sakar B, Alici S, Argon A, et al. Anemia in oncology practice: relation to diseases and their therapies. American journal of clinical oncology. 2002;25(4):371-9.
• Referans 21 Gierth M, Mayr R, Aziz A, Krieger S, Wullich B, Pycha A, et al. Preoperative anemia is associated with adverse outcome in patients with urothelial carcinoma of the bladder following radical cystectomy. Journal of cancer research and clinical oncology. 2015;141(10):1819-26.
• Referans 22 Janssens GO, Rademakers SE, Terhaard CH, Doornaert PA, Bijl HP, van den Ende P, et al. Improved recurrence-free survival with ARCON for anemic patients with laryngeal cancer. Clinical cancer research. 2014;20(5):1345-54.
• Referans 23 Qiu M-z, Yuan Z-y, Luo H-y, Ruan D-y, Wang Z-q, Wang F-h, et al. Impact of pretreatment hematologic profile on survival of colorectal cancer patients. Tumor Biology. 2010;31(4):255-60.
• Referans 24 Song S, Li C, Li S, Gao H, Lan X, Xue Y. Derived neutrophil to lymphocyte ratio and monocyte to lymphocyte ratio may be better biomarkers for predicting overall survival of patients with advanced gastric cancer. OncoTargets and therapy. 2017;10:3145.
• Referans 25 Sun X, Liu X, Liu J, Chen S, Xu D, Li W, et al. Preoperative neutrophil-to-lymphocyte ratio plus platelet-to-lymphocyte ratio in predicting survival for patients with stage I–II gastric cancer. Chinese journal of cancer. 2016;35(1):57.
• Referans 26 Clinical practice guidelines on cancer-related anemia (2012-2013 Edition). Chinese clinical oncology. 2012;1(2):18.
• Referans 27 Washington K. of the AJCC cancer staging manual: stomach. Annals of surgical oncology. 2010;17(12):3077-9.
• Referans 28 Griniatsos J, Papaconstantinou I, Felekouras E, Michail P, Bakoyiannis C, Bramis J. The significance of perioperative anemia in patients with resectable gastrointestinal tract tumors. JOURNAL-BALKAN UNION OF ONCOLOGY. 2004;9:247-54.
• Referans 29 Birgegård G, Aapro MS, Bokemeyer C, Dicato M, Drings P, Hornedo J, et al. Cancer-related anemia: pathogenesis, prevalence and treatment. Oncology. 2005;68(Suppl. 1):3-11.
• Referans 30 Wilson M, Van Haaren M, Harlaar JJ, Park HC, Bonjer HJ, Jeekel J, et al. Long-term prognostic value of preoperative anemia in patients with colorectal cancer: a systematic review and meta-analysis. Surgical Oncology. 2017;26(1):96-104.
• Referans 31 Huang X-z, Yang Y-c, Chen Y, Wu C-c, Lin R-f, Wang Z-n, et al. Preoperative anemia or low hemoglobin predicts poor prognosis in gastric cancer patients: a meta-analysis. Disease markers. 2019;2019.
• Referans 32 Dachs G, Tozer G. Hypoxia modulated gene expression: angiogenesis, metastasis and therapeutic exploitation. European Journal of Cancer. 2000;36(13):1649-60.
• Referans 33 Vaupel P, Thews O, Hoeckel M. Treatment resistance of solid tumors. Medical oncology. 2001;18(4):243-59.
• Referans 34 Semenza GL. Hypoxia, clonal selection, and the role of HIF-1 in tumor progression. Critical reviews in biochemistry and molecular biology. 2000;35(2):71-103.
• Referans 35 Ludwig H, Van Belle S, Barrett-Lee P, Birgegård G, Bokemeyer C, Gascón P, et al. The European Cancer Anaemia Survey (ECAS): a large, multinational, prospective survey defining the prevalence, incidence, and treatment of anaemia in cancer patients. European journal of cancer. 2004;40(15):2293-306.
• Referans 36 Khorana AA, Francis CW, Blumberg N, Culakova E, Refaai MA, Lyman GH. Blood transfusions, thrombosis, and mortality in hospitalized patients with cancer. Archives of internal medicine. 2008;168(21):2377-81.
• Referans 37 Reim D, Strobl AN, Buchner C, Schirren R, Mueller W, Luppa P, et al. Perioperative transfusion of leukocyte depleted blood products in gastric cancer patients negatively influences oncologic outcome: a retrospective propensity score weighted analysis on 610 curatively resected gastric cancer patients. Medicine. 2016;95(29).
• Referans 38 Xue L, Chen X-L, Wei-Han Z, Yang K, Chen X-Z, Zhang B, et al. Impact of perioperative blood transfusion on postoperative complications and prognosis of gastric adenocarcinoma patients with different preoperative hemoglobin value. Gastroenterology Research and Practice. 2016;2016.
• Referans 39 Liu X, Qiu H, Huang Y, Xu D, Li W, Li Y, et al. Impact of preoperative anemia on outcomes in patients undergoing curative resection for gastric cancer: a single‐institution retrospective analysis of 2163 Chinese patients. Cancer medicine. 2018;7(2):360-9.
• Referans 40 Shen JG, Cheong JH, Hyung WJ, Kim J, Choi SH, Noh SH. Pretreatment anemia is associated with poorer survival in patients with stage I and II gastric cancer. Journal of surgical oncology. 2005;91(2):126-30.