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International Journal of Clinical Oncology

, Volume 23, Issue 4, pp 671–680 | Cite as

Total iron-binding capacity is a novel prognostic marker after curative gastrectomy for gastric cancer

  • Hiroshi Sawayama
  • Masaaki Iwatsuki
  • Daisuke Kuroda
  • Tasuku Toihata
  • Tomoyuki Uchihara
  • Yuki Koga
  • Taisuke Yagi
  • Yuki Kiyozumi
  • Tsugio Eto
  • Yukiharu Hiyoshi
  • Takatsugu Ishimoto
  • Yoshifumi Baba
  • Yuji Miyamoto
  • Naoya Yoshida
  • Hideo Baba
Original Article
  • 93 Downloads

Abstract

Background

Patients with gastric cancer (GC) are affected by changes in iron status. Before surgery, GC patients are likely to have iron-deficiency anemia; and after gastrectomy, patients suffer from low nutritional status and low iron. This study investigated preoperative iron status associated with prognosis after curative gastrectomy for gastric cancer.

Methods

We evaluated preoperative serum hemoglobin (Hgb), Fe and total iron-binding capacity (TIBC) in 298 patients who underwent curative gastrectomy for GC without preoperative chemotherapy, and analyzed these factors’ associations with prognosis after surgery.

Results

Of the 298 patients, 129 (43.2%) had low Hgb levels, and 33 (11.1%) had low TIBC (< 260 µg/dl) that was not associated with Hgb or Fe level. Patients with low TIBC were significantly associated with older age (≥ 65 years old; P = 0.0085), low albumin (< 3.9 g/dl; P = 0.0388) and high CRP (≥ 0.15 mg/dl; P = 0.0018) in multivariate analysis. Low Fe (< 60 µg/dl) was not associated with disease-free survival (DFS) or overall survival (OS); however, low Fe was associated with longer cancer-specific survival in Stage III GC patients (P = 0.0333). Both low Hgb and low TIBC were significantly associated with shorter DFS (Hgb: P = 0.0433; TIBC: P < 0.0001) and shorter OS (Hgb: P = 0.0352; TIBC: P < 0.0001). Low TIBC were significantly associated with shorter DFS (HR 2.167, 95% CI 1.231–3.639, P = 0.0086) and shorter OS (HR 2.065, 95% CI 1.144–3.570, P = 0.0173) in multivariate Cox hazard regression analysis.

Conclusions

Preoperative serum TIBC level of GC patients who undergo curative gastrectomy is a novel prognostic marker in univariate and multivariate analyses.

Keywords

Prognosis Fe TIBC Iron status 

Notes

Acknowledgements

We thank Marla Brunker, from Edanz Group (www.edanzediting.com/ac) for editing a draft of this manuscript.

Compliance with ethical standards

Conflict of interest

No author has any conflict of interest.

Ethical standards

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1964 and later versions. All patients gave informed consent for being included in the study.

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Copyright information

© Japan Society of Clinical Oncology 2018

Authors and Affiliations

  • Hiroshi Sawayama
    • 1
  • Masaaki Iwatsuki
    • 1
  • Daisuke Kuroda
    • 1
  • Tasuku Toihata
    • 1
  • Tomoyuki Uchihara
    • 1
  • Yuki Koga
    • 1
  • Taisuke Yagi
    • 1
  • Yuki Kiyozumi
    • 1
  • Tsugio Eto
    • 1
  • Yukiharu Hiyoshi
    • 1
  • Takatsugu Ishimoto
    • 1
  • Yoshifumi Baba
    • 1
  • Yuji Miyamoto
    • 1
  • Naoya Yoshida
    • 1
  • Hideo Baba
    • 1
  1. 1.Department of Gastroenterological Surgery, Graduate School of Medical SciencesKumamoto UniversityKumamotoJapan

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