TY - JOUR
T1 - Preoperative hemoglobin count and prognosis of esophageal cancer, a population-based nationwide study in Finland
AU - on behalf of the FINEGO group
AU - Jokela, Ella M.K.
AU - Kauppila, Joonas H.
AU - Helminen, Olli
AU - Helmiö, Mika
AU - Huhta, Heikki
AU - Kallio, Raija
AU - Koivukangas, Vesa
AU - Kokkola, Arto
AU - Laine, Simo
AU - Lietzen, Elina
AU - Meriläinen, Sanna
AU - Ohtonen, Pasi
AU - Pohjanen, Vesa Matti
AU - Rantanen, Tuomo
AU - Ristimäki, Ari
AU - Räsänen, Jari V.
AU - Saarnio, Juha
AU - Sihvo, Eero
AU - Toikkanen, Vesa
AU - Tyrväinen, Tuula
AU - Valtola, Antti
N1 - Funding Information:
This study was funded by the Finnish Cancer Foundation, Sigrid Juselius Foundation, P?ivikki and Sakari Sohlberg Foundation, and Orion Research Foundation. The funders had no role in designing the study, data collection, analysis, writing the manuscript, or submitting the manuscript to publication.
Funding Information:
This study was funded by the Finnish Cancer Foundation , Sigrid Juselius Foundation , Päivikki and Sakari Sohlberg Foundation , and Orion Research Foundation . The funders had no role in designing the study, data collection, analysis, writing the manuscript, or submitting the manuscript to publication.
Publisher Copyright:
© 2021
PY - 2021/8/17
Y1 - 2021/8/17
N2 - Background: The prognostic value of preoperative hemoglobin in patients undergoing esophagectomy is unknown. The aim of this study was to examine whether preoperative hemoglobin is associated with prognosis in patients undergoing esophagectomy for cancer. Materials and methods: This was a population-based nationwide retrospective cohort study in Finland, using Finnish National Esophago-Gastric Cancer Cohort (FINEGO). Esophagectomy patients with available preoperative hemoglobin measurement were included. Multivariable cox regression provided hazard ratios (HR) with 95% confidence intervals (CI), adjusted for calendar period of surgery, age at surgery, sex, comorbidity (Charlson Comorbidity Index), tumor histology, tumor stage, neoadjuvant therapy, type of surgery (minimally invasive or open) and annual hospital volume. Results: Of the 1313 patients, 932 (71.0%) were men and 799 (60.9%) had esophageal adenocarcinoma. Overall all-cause mortality was significantly higher in the lowest hemoglobin count tertile (HR 1.26 (1.07–1.47)) compared to the highest tertile, but this association was attenuated after adjustment for confounding. No differences were found between the preoperative hemoglobin groups in the adjusted analyses of 90-day all-cause, 5-year all-cause, and 5-year cancer-specific mortality. Conclusion: In this population-based nationwide study, preoperative hemoglobin count had no independent prognostic significance in esophageal cancer.
AB - Background: The prognostic value of preoperative hemoglobin in patients undergoing esophagectomy is unknown. The aim of this study was to examine whether preoperative hemoglobin is associated with prognosis in patients undergoing esophagectomy for cancer. Materials and methods: This was a population-based nationwide retrospective cohort study in Finland, using Finnish National Esophago-Gastric Cancer Cohort (FINEGO). Esophagectomy patients with available preoperative hemoglobin measurement were included. Multivariable cox regression provided hazard ratios (HR) with 95% confidence intervals (CI), adjusted for calendar period of surgery, age at surgery, sex, comorbidity (Charlson Comorbidity Index), tumor histology, tumor stage, neoadjuvant therapy, type of surgery (minimally invasive or open) and annual hospital volume. Results: Of the 1313 patients, 932 (71.0%) were men and 799 (60.9%) had esophageal adenocarcinoma. Overall all-cause mortality was significantly higher in the lowest hemoglobin count tertile (HR 1.26 (1.07–1.47)) compared to the highest tertile, but this association was attenuated after adjustment for confounding. No differences were found between the preoperative hemoglobin groups in the adjusted analyses of 90-day all-cause, 5-year all-cause, and 5-year cancer-specific mortality. Conclusion: In this population-based nationwide study, preoperative hemoglobin count had no independent prognostic significance in esophageal cancer.
KW - Esophageal cancer
KW - Esophagectomy
KW - Hemoglobin
KW - Mortality
KW - Prognosis
U2 - 10.1016/j.ejso.2021.08.020
DO - 10.1016/j.ejso.2021.08.020
M3 - Article
AN - SCOPUS:85113313918
SN - 0748-7983
JO - European Journal of Surgical Oncology
JF - European Journal of Surgical Oncology
ER -
