Due to the low incidence of pretreatment anemia in nasopharyngeal carcinoma (NPC), the true prognostic impact of pretreatment anemia may be underestimated before. We retrospectively analyzed the association of pretreatment anemia with disease-specific survival (DSS), distant-metastasis-free survival (DMFS), and locoregional-relapse-free survival (LRFS) by Cox regression in a cohort of 5830 patients, stratifying by midtreatment anemia, smoking, body mass index (BMI), etc. Pretreatment anemia was significantly associated with adverse DSS (hazard ratio (HR) = 2.15, 95 % confidence interval (CI) 1.62–2.85, P < 0.001) and DMFS (HR = 1.53, 95 % CI 1.08–2.17, P = 0.018), comparing to patients with normal hemoglobin, after adjusting for covariates. Moreover, the association with DSS remained unchanged regardless of smoking status and clinical stage, whereas it was limited in the subgroups of above 45 years, male sex, and BMI <25 kg/m2. With restriction to midtreatment anemic patients, pretreatment anemia was still strongly correlated with inferior DSS and DMFS. This study, in the largest reported cohort, is the first to show the adverse prognostic impact of pretreatment anemia on DSS and DMFS in NPC.
Anemia Head and neck cancer Hemoglobin Nasopharyngeal carcinoma Survival
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All procedures performed in studies involving human participants were in accordance with the ethical standards of the Institutional Review Board at Sun Yat-sen University Cancer Center and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. For this retrospective study, formal consent is not required.
As a retrospective study, individual informed consent was waived given the anonymous analysis of routine data.
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