Influence of anemia on tumor response to preoperative chemoradiotherapy for locally advanced rectal cancer

In rectal cancer patients treated with preoperative chemoradiotherapy (CRT) and curative resection, we evaluated the influence of anemia on tumor response to preoperative CRT. Between August 2001 and July 2007, 490 patients underwent preoperative CRT, followed by curative-intent surgery. Tumor responses were evaluated based on tumor regression grade (TRG), T- and N-level downstaging, and volume reduction rates. The level of pretreatment hemoglobin (Hb) was 12.9 +/- 1.7 g/dl (range, 7.2-17.6 g/dl). Tumor response rates were significantly different below and above the Hb level of 9.0 g/dl. Specifically, patients with Hb levels a parts per thousand yen9.0 g/dl achieved better tumor responses than those with Hb levels < 9.0 g/dl (rates of TRG 3 or 4-29.0% vs. 0%, p < 0.001). In addition, there is no differences in tumor response between the nontransfusion and transfusion groups of patients with Hb levels a parts per thousand yen9.0 g/dl (rates of TRG 3 or 4-29.1% vs. 23.1%, p = 0.445). The serum Hb level could be a one of prognostic factors that influences the pathologic tumor response, and pretreatment anemia (below 9.0 g/dl of Hb) is associated with poor response to preoperative CRT.