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

This article has been archived.
Please use for reference only.

Albert DeNittis, MD
OncoLink Assistant Editor
Last Modified: November 1, 2001

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

-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.

ASTRO coverage is sponsored, in part, by Varian Medical Systems, Inc.