Abstract
Introduction: This study aimed to explore the relationship between blood hemoglobin (Hb) levels and clinical factors in patients with locally advanced rectal cancer (LARC). The primary objective was to comprehensively evaluate how Hb levels influence both the response to neoadjuvant chemoradiotherapy (NACRT) and the overall survival (OS) in this patient cohort.
Methods: In this study, we examined Hb levels in patients with LARC before treatment. Survival rates were evaluated using Kaplan-Meier and life-table methods. Additionally, a multivariate analysis was conducted using Cox regression to determine hazard ratios associated with different predictors of survival. A p-value of less than 0.05 was considered statistically significant.
Results: In our study of 343 patients with LARC, most were male (59.2%) with a mean age of 58.07 years. The average Hb level was 12.70 ± 1.76 mg/dL, and 43.4% of patients had anemia. Notably, lower pre-treatment Hb levels were associated with longer intraluminal tumor . Anemic patients also experienced more obstructive symptoms (68.2%). Survival analysis revealed that patients with normal Hb levels who responded well to treatment had significantly longer overall survival. Furthermore, multivariable analysis confirmed that moderate to severe anemia was an independent predictor of lower survival rates in LARC patients.
Conclusion: This study highlights the significant impact of severe anemia on reducing survival rates in patients with advanced rectal cancer. Conversely, a favorable response to treatment improves the chances of survival. However, further research with larger patient cohorts is needed to validate these findings.