Abstract
Background The prognostic value of preoperative anemia in gastric cancer remains unclear. Therefore, the purpose of the present study is to evaluate the prognostic value of preoperative anemia in gastric cancer. Methods We searched Embase and PubMed databases for relevant studies from inception to March 2018. The prognostic value of preoperative anemia in gastric cancer was determined by calculating the hazard ratio (HR) and the corresponding 95% confidence interval (CI) as effect measures. A random effect model was used in cases in which there was significant heterogeneity; otherwise, a fixed effect model was used. Statistical analyses were performed using Stata software. Results Seventeen studies involving 13,154 gastric cancer patients were included. The estimated rate of preoperative anemia was 36% (95%CI = 27-44%). The overall survival of preoperative anemia was poor (HR = 1.33, 95%CI = 1.21-1.45). Moreover, disease-free survival was significantly lower in patients with preoperative anemia compared with those without this condition (HR = 1.62, 95%CI = 1.13-2.32). These findings were corroborated by the results of subgroup analyses. Conclusions The results indicate that preoperative anemia predicts poor prognosis in gastric cancer, including overall survival and disease-free survival. Therefore, preoperative anemia may be a convenient and cost-effective blood-derived prognostic marker for gastric cancer.
Highlights
Gastric cancer is the fourth most frequently diagnosed cancer worldwide, accounting for approximately 951,600 new cases [1]
Several clinical studies have reported that the neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and monocyte-tolymphocyte ratio are inversely correlated with the prognosis of gastric cancer [3,4,5,6]
Our results indicated that preoperative anemia predicted poor OS in gastric cancer (HR = 1 33, 95%confidence interval (CI) = 1 21-1.45, degree of heterogeneity (I2) = 48 9%; Figure 2)
Summary
Gastric cancer is the fourth most frequently diagnosed cancer worldwide, accounting for approximately 951,600 new cases [1]. Blood-derived biomarkers have become attractive, convenient, and cost-effective prognostic markers to assess and predict the prognosis of gastric cancer. The prognostic value of preoperative anemia in gastric cancer remains unclear. The purpose of the present study is to evaluate the prognostic value of preoperative anemia in gastric cancer. Disease-free survival was significantly lower in patients with preoperative anemia compared with those without this condition (HR = 1 62, 95%CI = 1 13-2.32). These findings were corroborated by the results of subgroup analyses. The results indicate that preoperative anemia predicts poor prognosis in gastric cancer, including overall survival and disease-free survival. Preoperative anemia may be a convenient and costeffective blood-derived prognostic marker for gastric cancer
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