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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