Preoperative anemia is an independent prognostic factor for esophageal cancer patients who receive curative treatment

Aim: We retrospectively evaluated the impact of anemia during the perioperative period on short- and long-term outcomes in patients with resectable esophageal cancer receiving curative treatment.Patients: Medical records of patients who underwent curative resection at our university between 2005 and 2022 were reviewed.Results: A total of 198 patients were included. A preoperative hemoglobin cutoff of 11 g/dl was selected. Thirty-four patients had hemoglobin ＜11 g/dl (Hb-low group), and 164 patients had hemoglobin ＞11 g/dl (Hb-high group). The 3- and 5-year overall survival (OS) rates were 39.1% and 34.8% in the Hb-low group, compared to 70.3% and 62.1% in the Hb-high group (p=0.003). Univariate and multivariate analyses identified preoperative hemoglobin as an independent prognostic factor for OS (HR 1.809; 95% CI: 1.073-3.050, p=0.026). The 3- and 5-year recurrence-free survival (RFS) rates were 16.6% and 16.6% in the Hb-low group, compared to 51.8% and 45.1% in the Hb-high group (p＜0.001). Multivariate analysis also identified preoperative hemoglobin as an independent prognostic factor for RFS (HR 1.977; 95% CI: 1.240-3.151, p=0.004).Conclusion: Preoperative anemia is an independent prognostic factor in esophageal cancer patients. Our findings suggest it could guide treatment and management decisions.