IMPLICATIONS OF THE ANEMIC SYNDROME IN PATIENTS WITH COLORECTAL CANCER
Abstract
Colorectal cancer (CRC) is an important worldwide issue, being considered the third most common type of cancer. According World Health Organization, it represents 10% of all cancer cases, being considered the second leading cause of cancer-related deaths all over the world. Most common signs are blood on or in stool, alternation of constipations and/or diarrhea, abdominal pain, vomiting, weight loss, fatigue and shortness of breath, which may be sign of anemia. Among the many complications that can occur, both preoperative and postoperative, anemic syndrome is one of the most common hematological issues, having a major impact on the prognosis and evolution of patients. The main purpose for this study was to evaluate the prevalence of the anemic syndrome, as well as the correlations between tumor characteristics and severity of the anemia. A retrospective, single-center, descriptive study of 100 patients was conducted at the University Emergency Hospital of Bucharest between the years 2019-2020. Our study confirms a higher incidence of colorectal cancer among men, comparing to women, with the maximum incidence among patients between 60-69 years old. Anemic syndrome represents one of the most important hematological complications associated with colorectal cancers. The results obtained lean in favor of rising number of anemic patients on discharge, comparing to ones that were anemic on admission. Patients with stage III disease showed a worsening of anemic syndrome, comparing to ones in stage II or I of cancer. Same trend was also observed in patients with higher grade of tumor differentiating (G3) comparing to G2 and G1.
References
[2] Sawicki, T.; Ruszkowska, M.; Danielewicz, A.; Niedźwiedzka, E.; Arłukowicz, T.; Przybyłowicz, K.E. A Review of Colorectal Cancer in Terms of Epidemiology, Risk Factors, Development, Symptoms and Diagnosis. Cancers 2021, 13, 2025. https://doi.org/10.3390/cancers13092025
[3] American Cancer Society. Colorectal Cancer Facts & Figures 2023-2025. Atlanta: American Cancer Society, Inc. 2022.
[4] Gonzalez-Hermoso, F., Perez-Palma, J., Marchena-Gomez, J. et al. Can Early Diagnosis of Symptomatic Colorectal Cancer Improve the Prognosis?. World J. Surg. 28, 716–720 (2004). https://doi.org/10.1007/s00268-004-7232-8
[5] James R. Dunne, Debra Malone, J.Kathleen Tracy, Christopher Gannon, Lena M. Napolitano,
Perioperative Anemia: An Independent Risk Factor for Infection, Mortality, and Resource Utilization in Surgery, Journal of Surgical Research, Volume 102, Issue 2, 2002, Pages 237-244, ISSN 0022-4804, https://doi.org/10.1006/jsre.2001.6330.
[6] Harju E. Empty iron stores as a significant risk factor in abdominal surgery. JPEN J Parenter Enteral Nutr. 1988;12:282–285. doi: 10.1177/0148607188012003282
[7] Sadahiro S, Suzuki T, Tokunaga N, Mukai M, Tajima T, Makuuchi H, Saito T. Anemia in patients with colorectal cancer. J Gastroenterol. 1998 Aug;33(4):488-94. doi: 10.1007/s005350050120. PMID: 9719230.
[8] Beuran M, “Curs de chirurgie. Vol. II,” București: Editura Ilex, 2013, pp. 26–72.
[9] Young, C.J., Sweeney, J.L. and Hunter, A. (2000), Implications of Delayed Diagnosis in Colorectal Cancer. Aust. N.Z. J. Surg., 70: 635-638. https://doi.org/10.1046/j.1440-1622.2000.01916.x
[10] Winawer SJ, Fletcher RH, Miller L, Godlee F, Stolar MH, Mulrow CD, et al. Colorectal cancer screening: clinical guidelines and rationale. Gastroenterology. 1997;112:594-642 [Published errata in Gastroenterology 1997;112:1060 and 1998;114: 635]
[11] Compton CC. Colorectal carcinoma: Diagnostic, prognostic, and molecular features. Mod Pathol 2003;16:376–88.
[12] Compton CC. Optimal pathologic staging: Defining stage II disease. Clin Cancer Res 2007;13(22 Pt 2):6862s–70s.
[13] Kristoffer Derwinger, Karl Kodeda, Elinor Bexe-Lindskog & Helena Taflin (2010) Tumour differentiation grade is associated with TNM staging and the risk of node metastasis in colorectal cancer, Acta Oncologica, 49:1, 57-62, DOI: 10.3109/02841860903334411
[14] Sumit R. Majumdar, Robert H. Fletcher, Arthur T. Evans, How does colorectal cancer present? symptoms, duration, and clues to location, The American Journal of Gastroenterology, Volume 94, Issue 10, 1999, Pages 3039-3045, ISSN 0002-9270, https://doi.org/10.1016/S0002-9270(99)00510-9. (https://www.sciencedirect.com/science/article/pii/S0002927099005109)
[15] Ristescu, Irina, et al. "Perioperative anemia and transfusion in colorectal cancer patients." Chirurgia (Bucur) 114.2 (2019): 234-42.
[16] Melissa M. Center, Ahmedin Jemal, Elizabeth Ward; International Trends in Colorectal Cancer Incidence Rates. Cancer Epidemiol Biomarkers Prev 1 June 2009; 18 (6): 1688–1694. https://doi.org/10.1158/1055-9965.EPI-09-0090
[17] H. R. Andrew R Marley HN, “Molecular epidemiology of colorectal cancer.,” Mol. Epidemiol. Genet, vol. 7, no. 3, pp. 105–14, 2016
[18] S. A. Ansa BE, Coughlin SS, Alema-Mensah E, “Evaluation of Colorectal Cancer Incidence Trends in the United States (2000–2014),” J Clin Med, vol. 7, no. 2, p. 22.
[19] Launoy G, Le Coutour X, Gignoux M, et alInfluence of rural environment on diagnosis, treatment, and prognosis of colorectal cancer.Journal of Epidemiology & Community Health 1992;46:365-367.
[20] Chyke A. Doubeni, Adeyinka O. Laiyemo, George Reed, Terry S. Field, Robert H. Fletcher; Socioeconomic and Racial Patterns of Colorectal Cancer Screening among Medicare Enrollees in 2000 to 2005. Cancer Epidemiol Biomarkers Prev 1 August 2009; 18 (8): 2170–2175. https://doi.org/10.1158/1055-9965.EPI-09-0104
[21] M.F. De Marco, M.L.G. Janssen-Heijnen, L.H. van der Heijden, J.W.W. Coebergh, Comorbidity and colorectal cancer according to subsite and stage: a population-based study, European Journal of Cancer, Volume 36, Issue 1, 2000, Pages 95-99, ISSN 0959-8049, https://doi.org/10.1016/S0959-8049(99)00221-X.
[22] Daniel Boakye, Bettina Rillmann, Viola Walter, Lina Jansen, Michael Hoffmeister, Hermann Brenner, Impact of comorbidity and frailty on prognosis in colorectal cancer patients: A systematic review and meta-analysis, Cancer Treatment Reviews, Volume 64, 2018, Pages 30-39, ISSN 0305-7372, https://doi.org/10.1016/j.ctrv.2018.02.003.
(https://www.sciencedirect.com/science/article/pii/S0305737218300136)
[23] S. T. Sadahiro S, Suzuki T, Tokunaga N, Mukai M, Tajima T, Makuuchi H, “Anemia in patients with colorectal cancer,” J Gastroenterol., vol. 33, pp. 488–494, 1998.
