University of Oulu

Jokela, E. M. K., Kauppila, J. H., Helminen, O., Helmiö, M., Huhta, H., Kallio, R., Koivukangas, V., Kokkola, A., Laine, S., Lietzen, E., Meriläinen, S., Ohtonen, P., Pohjanen, V.-M., Rantanen, T., Ristimäki, A., Räsänen, J. V., Saarnio, J., Sihvo, E., Toikkanen, V., … Valtola, A. (2022). Preoperative hemoglobin count and prognosis of esophageal cancer, a population-based nationwide study in Finland. European Journal of Surgical Oncology, 48(3), 548–552.

Preoperative hemoglobin count and prognosis of esophageal cancer, a population-based nationwide study in Finland

Saved in:
Author: Jokela, Ella M.K.1; Kauppila, Joonas H.1,2; Helminen, Olli1;
Organizations: 1Surgery Research Unit, Oulu University Hospital and University of Oulu, Oulu, Finland
2Upper Gastrointestinal Surgery, Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
3The Division of Digestive Surgery and Urology, Turku University Hospital and University of Turku, Turku, Finland
4Department of Oncology and Radiotherapy, Oulu University Hospital, Oulu, Finland
5Department of Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
6Cancer and Translational Medicine Research Unit, Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland
7Department of Surgery, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland
8Department of Pathology and HUSLAB, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
9Applied Tumor Genomics Research Program, Research Programs Unit, University of Helsinki, Helsinki, Finland
10Department of Oesophageal and General Thoracic Surgery, Helsinki University Hospital and University of Helsinki, Finland
11Department of Surgery, Central Finland Central Hospital, Jyväskylä, Finland
12Department of Cardiothoracic Surgery, Heart Center, Tampere University Hospital and University of Tampere, Tampere, Tampere, Finland
13Department of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital, Tampere, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.3 MB)
Persistent link:
Language: English
Published: Elsevier, 2022
Publish Date: 2023-06-29


Background: The prognostic value of preoperative hemoglobin in patients undergoing esophagectomy is unknown. The aim of this study was to examine whether preoperative hemoglobin is associated with prognosis in patients undergoing esophagectomy for cancer.

Materials and methods: This was a population-based nationwide retrospective cohort study in Finland, using Finnish National Esophago-Gastric Cancer Cohort (FINEGO). Esophagectomy patients with available preoperative hemoglobin measurement were included. Multivariable cox regression provided hazard ratios (HR) with 95% confidence intervals (CI), adjusted for calendar period of surgery, age at surgery, sex, comorbidity (Charlson Comorbidity Index), tumor histology, tumor stage, neoadjuvant therapy, type of surgery (minimally invasive or open) and annual hospital volume.

Results: Of the 1313 patients, 932 (71.0%) were men and 799 (60.9%) had esophageal adenocarcinoma. Overall all-cause mortality was significantly higher in the lowest hemoglobin count tertile (HR 1.26 (1.07–1.47)) compared to the highest tertile, but this association was attenuated after adjustment for confounding. No differences were found between the preoperative hemoglobin groups in the adjusted analyses of 90-day all-cause, 5-year all-cause, and 5-year cancer-specific mortality.

Conclusions: In this population-based nationwide study, preoperative hemoglobin count had no independent prognostic significance in esophageal cancer.

see all

Series: European journal of surgical oncology
ISSN: 0748-7983
ISSN-E: 1532-2157
ISSN-L: 0748-7983
Volume: 48
Issue: 3
Pages: 548 - 552
DOI: 10.1016/j.ejso.2021.08.020
Type of Publication: A1 Journal article – refereed
Field of Science: 3126 Surgery, anesthesiology, intensive care, radiology
3122 Cancers
Copyright information: © 2021 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY license (