Anemia has been implicated as a significant factor in the failure of response for solid tumors in patients undergoing radiation therapy and chemotherapy. The purpose of our study was to analyze the correlation of preoperative hemoglobin levels and survival after surgical resection for early stage lung cancer.
All patients undergoing resection for Stage I and II non-small lung cancer from January 2002 through December 2003 comprised the cohort. Patients were followed up to December 2004 or death. Demographics and risk factors, including age, prior thoracic surgery, coronary artery disease, congestive heart failure, hypertension, diabetes, renal failure, peripheral vascular disease, steroid use, ASA classification, Zubrod score, and neoadjuvent therapy, were analyzed along with preoperative hemoglobin levels. Data was collected prospectively, based on Society of Thoracic Surgeons database model.
Preoperative hemoglobin was found to be an independent predictor of intermediate survival for patients undergoing surgical resection for early stage lung cancer. Hemoglobin levels greater than 14 resulted in 100 percent survival as compared to levels less than 12 which resulted in a 73.7 percent survival during the follow-up period. Using the Pearson Correlation, hemoglobin was a significant factor in survival (p = 0.007). The mean time to death was shortest in Group I, 5.41 (0.1-13.8). One death occurred in perioperative period in the cohort, Group I. There was one transfusion in the cohort, group III.
For patients with non-small cell lung cancer undergoing surgical resection, hemoglobin was found to be a predictor of survival. The exact mechanism or cause/effect relationship is theoretical at this time. The effects of tissue hypoxemia and free radical generation need to be studied to assess the effects they have on tumor cell survival.
Further investigation is warranted to determine if hemoglobin is a marker of overall risk or if it is a determinant of survival. Additionally, the question of optimization of preoperative hemoglobin prior to surgical therapy and its effect on survival should also be investigated.
GroupsHemoglobin (G/DL)FrequencyPercentRangeMeanI9.7-12.011.1Alive 1470Dead 630II12.1-13.012.5Alive 1886Dead 314III13.1-13.913.48Alive 1689Dead 211IV14.0-16.114.85Alive 20100Dead 00
Cliff Connery, None.