Berna AKKUŞ YILDIRIM, Ahmet Taner SÜMBÜL, Ozan Cem GÜLER, Ali Murat SEDEF, Cem ÖNAL, Erkan TOPKAN

Preoperatif kemoradyoterapi uygulanan lokal ileri rektum kanserli hastalarda tedavi öncesi hemoglobin düzeyinin prognostik rolü

Amaç: Bu çalışmada lokal ileri rektum kanserli hastalarda neoadjuvan kemoradyoterapi öncesi basit uygulanabilir, en temel parametrelerden birisi olan hemoglobin (Hb) seviyesi ile genel sağkalım arasındaki ilişkiyi araştırmayı amaçladık.Gereç ve Yöntem: Neoadjuvan kemoradyoterapi tedavisi sonrasında cerrahi uygulanan 123 lokal ileri rektum kanseri tanılı hasta retrospektif olarak çalışmamızda değerlendirildi. Tüm hastaların tedavi öncesi Hb değerleri bağımsız değişken olarak kaydedildi. Birincil amacımız tedavi Hb seviyesinin genel sağkalıma etkisi olarak belirlendi. Bulgular: Çalışmanın ortalama izlem süresi 40,3 ay (1,4-92ay) olarak tespit edildi. Yapılan ROC analizine göre Hb’nin cut-off değeri 12.5g/dl (AUC=0,673, %95 0.564-0.781) bulundu. Grup Hb’nin cut-off değerine göre normal-Hb (nHb; Hb>12) ve düşük-Hb (dHb≤12) iki gruba ayrıldığında nHb olan grupta Hb’ni düşük olan gruba göre genel sağkalım istatistiksel olarak daha uzun saptandı. Çok değişkenli analizde de p değeri anlamlılığını korudu.Sonuç: Neoadjuvan kemoradyoterapi tedavisi planlanan lokal ileri rektum kanseri tanılı hastalarda tedavi öncesi Hb değerinin bağımsız bir prognostik faktör olduğu düşünüldü.

Anahtar Kelimeler:

Rektum Kanser, Kemoradyoterapi, Hemoglobin, Prognostik

Prognostic role of pretreatment level hemoglobin levels in patients with local advanced rectum cancer treated with preoperative chemotherapy

Purpose: This study aims to systematically evaluate the relationship between baseline blood count levels, simply and basically initiated, and treatment response in locally advanced rectal cancer patients treated with neoadjuvant chemoradiotherapy.Materials and Methods: This retrospective study included 123 locally advanced rectal cancer patients who were treated with neoadjuvant chemoradiotherapy followed by surgery. Pretreatment Hb level was assessed as an independent variable for the whole study sample .The primary endpoint was the impact of pre-treatment Hb levels on overall survival. Results: At a median follow-up of 40,3 months (1,4-92 months). A Hb cut-off value of 12.5 g/dl (AUC=0.673, %95 0.564-0.781) was identified by using ROC analysis. Following the stratification of patients at this cut-off point into two groups: normal-Hb (nHb; Hb>12) and low-Hb (dHb≤12), the comparative survival analysis demonstrated that the patients in the nHb group had significantly increased OS than those in the dHb group, and retained its independent significant association with survival outcomes in the multivariate analysis. Conclusion: Knowledge of pretreatment hematological parameters appears to be an important prognostic factor in patients with rectal carcinoma.

Keywords:

rectum cancer, hemoglobin,

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