Anemia is associated with decreased local control of surically treated squamous cell carcinoma of the glottic larynx

Albert DeNittis, MD
OncoLink Assistant Editor
Last Modified: November 2, 1999

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Presenter: Guttenberger R
Affiliation: University of Freiberg, Freiberg, Germany

Summary:
-There is a known correlation between anemia and local control in head and neck cancer. -This study was performed to demonstrate a difference in treatment outcome in patients with a low pretreatment hemoglobin who recieved surgery alone. -From January 1970 to December of 1990 258 patients with squamous cell carcinoma of the glottis were treated with surgery alone. -T1/T2/T3/T4 n=188/31/37/2 -median hemoglobin was 14.5 -Local regional control rates were calculated using Kaplan Meier and the one sided log-rank test was used to detect differences in anemia. -The influence of anemia was was evaluated using a proportional hazards model. -Fiveyear locoregional control was 91%/85%/76%/62%/ 0% for stages T1a/T1b/T2/T3/T4 repectively -Anemia was defined as hemoglobin <13 for males and <12 for females. -Anemia was associated with a significantly worse prognosis -60% for anemic patients versus 85% locoregional control for nonanemic patients. -In addition, patients with comparable T1 tumors (162) patients were analyzed with univariate Kaplan-Meier methods for groups of patients with hemoglobin values of <13.5/13.5-14.4/14.4-15.4/>15.5. -Locoregional control was 84%/88%/92%/97% for the respective groups. This suggests that hemoglobin might be a continuous risk factor. -Hemoglobin increase of 2 gram % increases locoregional control from 50% to 65% at 5 years

Clinical/Scientific Implications:
-Anemia is associated with a high risk of treatment failure in surgically treated glottic cancer. -Hemoglobin levels in the normal range may also be associated with a decrease in locoregional control for squamous cell carcinoma of the glottis.

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