Prevalence, severity, and evolution of postsurgical anemia after gastrectomy, and clinicopathological factors affecting its recovery

PURPOSE Postsurgical anemia is one of the common unpleasant postoperative sequels during the early postoperative period after gastrectomy, for which no standard care has been established. To facilitate proper management, we investigated the clinical features of postsurgical anemia and sought to identify the factors affecting its subsequent recovery. METHODS A retrospective review of 406 consecutive gastric cancer patients who underwent gastrectomy without systemic chemotherapy between August 2008 and September 2009. Clinical courses of postsurgical anemia were monitored at 3, 6, and 12 months post-surgery. Clinicopathological factors affecting recovery of postsurgical anemia were analyzed using a multivariate logistic regression model. RESULTS The study subjects consisted of 265 males and 141 females (mean age, 61.8 years). After operation, 318 (78.3%) presented with postsurgical anemia, and 217 (66.7%) and 47 (11.6%) had mild or moderate anemia, respectively, at the time of discharge. During the follow-up, 173 (54.4%) of the 318 with postsurgical anemia showed a spontaneous recovery at 3 months post-surgery, but no significant changes were observed in postsurgical anemia at 6 or 12 months post-surgery. Univariate and multivariate analysis revealed that old age (≥60 years), preoperative anemia, anemia severity (moderate anemia), and total gastrectomy were independent factors that adversely affect the spontaneous recovery of post-surgical anemia after gastrectomy. CONCLUSION Proper intervention may be required for postsurgical anemia that does not achieve a spontaneous recovery until postoperative 3 months. However, proper management, such as the use of iron or the best route for iron supplementation, needs to be evaluated in future clinical trials.