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Post-diagnosis hemoglobin change associates with overall survival of multiple malignancies - results from a 14-year hospital-based cohort of lung, breast, colorectal, and liver cancers
Wan S.1; Lai Y.1; Myers R.E.1; Li B.3; Palazzo J.P.1; Burkart A.L.1; Chen G.2; Xing J.4; Yang H.1
2013-07-10
Source PublicationBMC Cancer
ISSN14712407
Volume13
Abstract

Background: Anemia refers to low hemoglobin (Hb) level and is a risk factor of cancer patient survival. The National Comprehensive Cancer Network recently suggested that post-diagnosis Hb change, regardless of baseline Hb level, indicates the potential presence of anemia. However, there is no epidemiological study evaluating whether Hb change has direct prognostic values for cancer patients at the population level.Methods: We identified 6675 patients with a diagnosis of primary lung, breast, colorectal, or liver cancer who visited the Kimmel Cancer Center at the Thomas Jefferson University from 1998 to 2011. All patients had at least two Hb measurements within the first six months after diagnosis. We analyzed the main, dose-dependent, and time-dependent effects of Hb changes on patient survival.Results: Compared to patients with a low Hb change (|{increment}Hb|≤2.6), those having a |{increment}Hb|>2.6 exhibited a significantly shorter survival (hazard ratio=1.40, 95% confidence interval 1.31-1.50, P=4.5 × 10, P=1.6 × 10). This association remained significant across the four cancer types. Bootstrap resampling validated these findings 100% of the time with P<0.01 in all patients and in patients of individual cancers. The association exhibited an apparent U-shape dose-dependent pattern. Time-dependent modeling demonstrated that the effect of Hb change on the survival of the overall patient population persisted for approximately 4.5 years after diagnosis.Conclusion: Post-diagnosis Hb change associates with the survival of multiple cancers and may have clinical values in tailoring anti-anemia treatments. Because Hb level is frequently measured during cancer treatment, Hb changes may be a potentially important variable in building cancer prognosis models. © 2013 Wan et al.; licensee BioMed Central Ltd.

KeywordHemoglobin Prognosis Survival
DOI10.1186/1471-2407-13-340
URLView the original
Indexed BySCI
Language英语
WOS Research AreaOncology
WOS SubjectOncology
WOS IDWOS:000321774400002
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Cited Times [WOS]:11   [WOS Record]     [Related Records in WOS]
Document TypeJournal article
CollectionFaculty of Health Sciences
Affiliation1.Thomas Jefferson University
2.National Heart, Lung, and Blood Institute
3.Vanderbilt University
4.The Fourth Military Medical University
Recommended Citation
GB/T 7714
Wan S.,Lai Y.,Myers R.E.,et al. Post-diagnosis hemoglobin change associates with overall survival of multiple malignancies - results from a 14-year hospital-based cohort of lung, breast, colorectal, and liver cancers[J]. BMC Cancer,2013,13.
APA Wan S..,Lai Y..,Myers R.E..,Li B..,Palazzo J.P..,...&Yang H..(2013).Post-diagnosis hemoglobin change associates with overall survival of multiple malignancies - results from a 14-year hospital-based cohort of lung, breast, colorectal, and liver cancers.BMC Cancer,13.
MLA Wan S.,et al."Post-diagnosis hemoglobin change associates with overall survival of multiple malignancies - results from a 14-year hospital-based cohort of lung, breast, colorectal, and liver cancers".BMC Cancer 13(2013).
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