Cancer Management and Research (Aug 2020)
Correlation Between Hemoglobin Levels and the Prognosis of First-Line Chemotherapy in Patients with Advanced Gastric Cancer
Abstract
Qing Wei,* Xing Yuan,* Qi Xu, Jingjing Li, Lei Chen, Jieer Ying Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital); Institute of Cancer and Basic Medicine (ICBM), Chinese Academy of Sciences, Hangzhou 310022, People’s Republic of China*These authors contributed equally to this workCorrespondence: Jieer YingCancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital); Institute of Cancer and Basic Medicine (ICBM), Chinese Academy of Sciences, Hangzhou 310022, People’s Republic of ChinaEmail [email protected]: This retrospective study evaluated the prognostic significance of hemoglobin (Hb) levels in patients (pts) with unresectable locally advanced or metastatic gastric cancer who have not previously received chemotherapy.Patients and Methods: We screened 249 pts with advanced gastric cancer, who were categorized into four groups, namely, non-anemia (normal Hb levels), mild (10 g/dl to normal), moderate (8– 10 g/dl), and severe anemia groups (< 8 g/dl), to study the prognostic significance of Hb levels. We also examined the correlation between changes in Hb levels and treatment effects via imaging during the treatment course.Results: The objective response rate (ORR) was 47.4% for pts with anemia versus 43.4% for pts without anemia (P=0.536). Hemoglobin levels were reduced by 0.51 ± 1.86 and 1.93 ± 1.33 g/dl after chemotherapy versus before chemotherapy in the disease control group and progressive groups, respectively (P=0.002). The median progression-free survival (mPFS) of first-line chemotherapy in all pts was 6.3 months. Specifically, the mPFS was 5.7 months in pts with severe anemia, compared with 6.4 months for pts with non-severe anemia (Hb≥ 8g/dl). The median overall survival (mOS) of all pts was 14.0 months. In particular, the mOS was 15.0 months for pts with non-anemia and mild anemia (Hb≥ 10g/dl) versus 11.5 months for pts with moderate or severe anemia. In multivariate analysis, ascites and decreased Hb post-chemotherapy were identified as independent prognostic indicators for PFS and OS.Conclusion: Our findings indicate that Hb levels are associated with the prognosis in the first-line chemotherapy for pts with advanced gastric cancer. Pts with progressive disease experience a larger decrease in Hb levels, and those with baseline Hb levels ≥ 10 g/dl experience longer OS.Keywords: anemic, hemoglobin, gastric cancer, prognosis
