A1 Journal article – refereed

Preoperative hemoglobin count and prognosis of esophageal cancer, a population-based nationwide study in Finland




List of Authors: Jokela Ella MK, Kauppila Joonas H; on behalf of the FINEGO group

Publisher: Elsevier

Publication year: 2021

Journal: EJSO - European Journal of Surgical Oncology

Journal name in source: European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology

Journal acronym: Eur J Surg Oncol

ISSN: 0748-7983

eISSN: 1532-2157

DOI: http://dx.doi.org/10.1016/j.ejso.2021.08.020


Abstract

Background

The prognostic value of preoperative hemoglobin in patients undergoing esophagectomy is unknown. The aim of this study was to examine whether preoperative hemoglobin is associated with prognosis in patients undergoing esophagectomy for cancer.

Materials and methods

This was a population-based nationwide retrospective cohort study in Finland, using Finnish National Esophago-Gastric Cancer Cohort (FINEGO). Esophagectomy patients with available preoperative hemoglobin measurement were included. Multivariable cox regression provided hazard ratios (HR) with 95% confidence intervals (CI), adjusted for calendar period of surgery, age at surgery, sex, comorbidity (Charlson Comorbidity Index), tumor histology, tumor stage, neoadjuvant therapy, type of surgery (minimally invasive or open) and annual hospital volume.

Results

Of the 1313 patients, 932 (71.0%) were men and 799 (60.9%) had esophageal adenocarcinoma. Overall all-cause mortality was significantly higher in the lowest hemoglobin count tertile (HR 1.26 (1.07–1.47)) compared to the highest tertile, but this association was attenuated after adjustment for confounding. No differences were found between the preoperative hemoglobin groups in the adjusted analyses of 90-day all-cause, 5-year all-cause, and 5-year cancer-specific mortality.

Conclusion

In this population-based nationwide study, preoperative hemoglobin count had no independent prognostic significance in esophageal cancer.

Keywords

Hemoglobin; Esophageal cancer; Esophagectomy; Mortality; Prognosis


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Last updated on 2021-14-09 at 12:10