The Prognostic Value of Anaemia at Different Treatment Times in Patients with Locally Advanced Head and Neck Cancer Treated with Surgery and Postoperative Radiotherapy

Abstract Aims We report a retrospective mono-institutional analysis of anaemia ( Materials and methods The end points for the statistical analysis in 130 patients were LRFS and overall survival. A univariate analysis (Log-rank test) was carried out on the following variables with potential end point-related impact: gender, T, N, G, American Joint Committee on Cancer (AJCC) stage, tumour site, resection status, overall treatment time (OTT), radiotherapy treatment time (RTT) and preoperative, postoperative, pre-radiotherapy and nadir levels of haemoglobin during radiotherapy. Individual variables with a significant effect ( P =0.05) were then subjected to multivariate Cox regression analysis. Results The median overall survival was 59 months. The univariate analysis showed that AJCC stage ( P =0.0268), resection status ( P =0.0407), preoperative haemoglobin level ( P =0.0087), postoperative haemoglobin level ( P =0.0035), RTT ( P =0.0042) and OTT ( P =0.0343) significantly influenced overall survival. OTT ( P =0.0130) and postoperative haemoglobin ( P =0.0243) had a significant effect on LRFS. The multivariate Cox regression analysis showed postoperative haemoglobin 100 days to be independent negative prognostic factors for both end points. Conclusions Postoperative acute anaemia 100 days were independent negative prognostic factors for LRFS and overall survival in patients with head and neck cancer treated with surgery and postoperative radiotherapy.