Pretreatment anemia as a prognostic factor on overall survival in nasopharyngeal cancer patients undergoing neoadjuvant therapyComment by Susanna: Kalau tdk signifikan judulnya disimplifikasi menjadi Pretreatment anemia in nasopharyngeal cancer patients undergoing neoadj txDominicus Wendhy Pramana1, Susanna Hilda Hutajulu2, Bambang Hariwiyanto3, Wigati Dhamiyati D4, Ibnu Purwanto2, Kartika Widayati Taroeno-Hariadi2, Johan Kurnianda2

1Study Program of Specialty in Internal Medicine, Department of Internal Medicine, Faculty of Medicine, Universitas Gadjah Mada, Yogyakarta, Indonesia2Division of Hematology and Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Universitas Gadjah Mada/Dr Sardjito General Hospital, Yogyakarta, Indonesia3Department of Ear, Nose, and Throat, Faculty of Medicine, Universitas Gadjah Mada/Dr Sardjito General Hospital, Yogyakarta, Indonesia4Division of Radiotherapy, Department of Radiology, Faculty of Medicine, Universitas Gadjah Mada/Dr Sardjito General Hospital, Yogyakarta, Indonesia

Introduction. Anemia is a common finding in cancer patients. Several studies suggest a negative impact of anemia for patients survival in different types of cancer, including nasopharyngeal cancer (NPC).Aim. This study aimed to analyze the prognostic role of pretreatment anemia on NPC patients undergoing neoadjuvant therapy.Methods. The data of 40 patients diagnosed as NPC between January 2007 and December 2011 and undergone underwent neoadjuvant therapy with cisplatin and 5-FU were retrospectively reviewed. Baseline hemoglobin concentration were evaluated at diagnosis. Hemoglobin concentration of less 13 g/dL for males, and less than 12 g/dL for females were defined as anemia. Along with other known prognostic factors (age, and sex), the prognostic value of pretreatment anemia were analyzed. Overall survival (OS) was assessed using the Kaplan-Meier method. Univariate and multivariate Cox regression models were used to evaluate independent prognostic significance.Comment by Susanna: Kalo ngga ada yg signifikan pakai univar analyzes sajaComment by Susanna: or was?Results. Pretreatment anemia was observed in 12 patients (30%). Median overall survival was 32.2 months (ranged from 28.2-37.5 months ). Patients with pretreatment anemia showed significantly lower median overall survival than those with normal hemoglobin concentration (21.3 vs 34.5 months, p = 0.044). In univariate analysis, pretreatment anemia had poorer prognosis on OS, although significance was not reached (HR = 2.68; 95% confidence interval/CI 0,98- 7,28). In multivariate analysis, none of the prognostic factors (pretreatment anemia, sex, and age) was awere significant factors for overall survivalOS of NPC patients undergoing neoadjuvant therapy (HR 3.92; 95% CI 0.66- 16.27, HR 0.46; 95% CI 0.06- 3.29, and HR 2.17 95% CI 0.36- 13.21, respectively).Comment by Susanna: Kalau univ tdk signifikan tdk diteruskan multivariat...Comment by Susanna: Ini dah diuji univariatnya? Biasanya yg univ signifikan baru dilanjutkan multivariat?Conclusion. The present study indicates that pretreatment anemia had predicted a poorer overall survivalOS in NPC patients who have undergone neoadjuvant therapy, eventhough significance was not achieved as an independent prognostic factor.Comment by Susanna: Bila NS, kalimatnya menjadi The present study showed that patients with pretreatment anemia had a worse median OS compared to those who did not showed any anemia. However, it did not have any prognostic impact on OS.