Anaemia – A Correctable Prognostic Factor for Resectable Colorectal Liver Metastasis – A Propensity Score-Matched Analysis

Introduction: Anaemia is common in patients suffered from colorectal cancer. It is an independent risk factor for blood transfusion, complications, prolonged stay and inferior outcome. We investigated the impact of anaemia in affecting the outcome in colorectal liver metastasis (CRLM). Methods: This is a retrospective review of CRLM received hepatectomy in a single institution from 2000 to 2019. Patients who suffered from anaemia were compared to those who had normal haemoglobin (Hb) level. A propensity-score matching analysis was performed to match the differences. Results: During the captioned period, there were total 311 patients identified. There were 162 patients had normal Hb level and 149 were anaemic. A propensity score matching analysis was performed for comorbidities, liver function and tumor status were performed in 1:1 ratio, giving two groups of 96 patients for comparison. There were more anaemic patients suffered from synchronous CRLM (p=0.001) and received more simultaneous live resection (p=0.022). There were more anaemic patients required blood transfusion (p=0.007). They also suffered from more major complications (p=0.016). The pathology was similar n both groups. The disease-free (5-year 34.3% vs 24.3%, p=0.066) and overall survival (5-year 56.2% vs 40.2%, p=0.007) were better for patients with normal Hb level. Multivariate analysis showed that preoperative anaemia (p=0.024) and occurrence of the major complication (p=0.003) were the independent poor prognostic factor for overall survival. Conclusions: Anaemia is a poor prognostic indicator in patients suffered from CRLM. Potential treatment in the preoperative period could be offered to improve the surgical and oncological outcome.