Anemia as a predictor of poor outcomes in colorectal cancer surgery: A literature review

Abstract

Background. Iron deficiency anemia is a frequent consequence of colorectal cancer (CRC) which might lead to poor treatment outcomes. Aim. To conduct a review analyzing the correlation between preoperative anemia and treatment outcomes (mortality, morbidity, survival) in CRC patients. Materials and methods. The literature search was conducted in PubMed (NCBI) and Cochrane databases. Key query terms: colorectal cancer, anemia, mortality and survival rates, blood loss, hemotransfusion. The review included articles discussing the prevalence of anemia in CRC and its association with mortality, morbidity, survival. Results. Anemia was found in 32–52% of CRC patients before surgery. It correlated well with higher incidence of postoperative morbidity and mortality as well as lower overall survival. The same findings were true regarding intraoperative blood loss and perioperative blood transfusion. Conclusions. Preoperative anemia is a major modifiable prognostic factor in CRC patients along with intraoperative blood loss and perioperative transfusion. Thus, strong efforts should be invested in the development of patient blood management protocols. The most effective method of solving this complex problem is the introduction into clinical practice of the patient blood management concept, which includes the use of intravenous iron preparations at the preoperative stage, correction of coagulopathy, a comprehensive approach to intraoperative blood conservation, an extremely strict approach in determining the indications for hemotransfusion.

Keywords

• colorectal cancer
• anemia
• blood loss
• blood transfusion