Significance of hemoglobin and hematocrit changes in predicting patient survival and efficacy of neoadjuvant chemotherapy for advanced gastric cancer

Table 1 Univariate analysis of factors associated with response to neoadjuvant chemotherapy for advanced gastric cancer, n (%)/mean ± SD

Relevant factors	Effective group (n = 121)	Ineffective group (n = 64)	x2/t value	P value
Gender			3.276	0.056
Male	80 (66.12)	45 (70.31)
Female	41 (33.88)	19 (29.69)
Age (years)			1.811	0.075
≤ 60	52 (42.98)	26 (40.63)
> 60	69 (57.02)	38 (59.37)
BMI (kg/m2)			1.542	0.087
≤ 24	103 (85.12)	53 (82.81)
> 24	18 (14.88)	11 (17.19)
ECOG score (points)			3.399	0.055
0	50 (41.32)	27 (42.19)
1	71 (58.68)	37 (57.81)
Smoking history			1.417	0.090
Yes	39 (32.23)	26 (40.63)
No	82 (67.77)	38 (59.37)
Drinking history			2.317	0.065
Yes	58 (47.93)	35 (54.69)
No	63 (52.07)	29 (45.31)
Tumor site			1.976	0.070
Cardiogastric fundus	39 (32.23)	21 (32.81)
Gastric body	17 (14.05)	9 (14.06)
Antrum of the stomach	59 (48.76)	26 (40.63)
Whole stomach	6 (4.96)	8 (12.50)
Tumor diameter (cm)			7.435	0.016
≤ 5	76 (62.81)	27 (42.19)
> 5	45 (37.19)	37 (57.81)
Histological type			6.632	0.024
Tubular adenocarcinoma	99 (81.82)	40 (62.50)
Poorly differentiated adenocarcinoma	10 (8.26)	12 (18.75)
Heron cell carcinoma	6 (4.96)	9 (26.47)
Mixed type	6 (4.96)	3 (8.83)
Degree of differentiation			1.605	0.084
High differentiated	5 (4.13)	1 (1.56)
Moderate differentiation	36 (29.75)	14 (21.88)
Poorly differentiated/undifferentiated	80 (66.12)	49 (76.56)
Lymph node metastasis			8.427	0.007
No	57 (47.11)	19 (29.69)
Yes	64 (52.89)	45 (70.31)
Severe adverse reactions			1.843	0.072
Yes	11 (9.09)	10 (15.63)
No	110 (90.91)	54 (84.37)
Chemotherapy cycle (cycles)			4.856	0.041
≤ 3	83 (68.60)	55 (85.94)
> 3	38 (31.40)	9 (14.06)
Hematocrit (%)			4.784	0.042
< 33	42 (34.71)	33 (51.54)
≥ 33	79 (65.29)	31 (48.44)
Mean corpuscular hemoglobin content (%)	55.27 ± 5.12	42.60 ± 4.83	2.678	0.009
Erythrocyte protein concentration (%)	15.23 ± 1.36	13.85 ± 2.06	2.292	0.036
Red blood cell distribution width	57.79 ± 2.74	45.56 ± 3.04	2.557	0.015
Hemoglobin (g/L)			7.996	0.010
< 107	57 (47.11)	45 (70.31)
≥ 107	64 (52.89)	19 (29.69)
Platelets (× 109/L)			5.785	0.033
> 266	62 (51.24)	51 (79.69)
≤ 266	59 (48.76)	13 (20.31)

BMI: Body mass index.

Table 2 Logistic multivariate analysis of factors associated with response to neoadjuvant chemotherapy for advanced gastric cancer

Factors	Beta	SE	Wald	OR	P value	95%CI
Tumor diameter > 5 cm	1.079	0.501	4.630	2.942	0.031	2.492-4.095
Lymph node metastasis	1.102	0.468	5.544	3.012	0.018	2.684-4.348
Chemotherapy cycles ≤ 3 cycles	0.577	0.204	7.996	1.782	0.004	3.283-4.174
Hematocrit < 33%	0.699	0.307	5.165	2.012	0.023	2.783-3.573
Hemoglobin < 107 g/L	0.833	0.379	4.814	2.301	0.028	2.485-4.128

OR: Odds ratio.

Table 3 Comparison of 3-year survival in patients with advanced gastric cancer treated with neoadjuvant chemotherapy, n (%)

Group	Number of cases (n)	1 year	2 years	3 years
Effective group	121	113 (93.39)	101 (83.47)	73 (60.33)
Effective group	64	45 (70.31)	23 (35.94)	18 (28.13)
χ² value		7.921	8.691	6.536
P value		0.012	0.004	0.025

Table 4 Comparison of 3-year survival of patients with different hemoglobin and hematocrit levels

Group	Number of cases (n)	1 year	2 years	3 years
Hematocrit (%)
< 33%	75	56 (74.67)	37 (49.33)	22 (29.33)
≥ 33%	110	102 (92.73)	87 (79.09)	69 (62.73)
χ² value		4.997	8.231	5.785
P value		0.040	0.009	0.033
Hemoglobin (g/L)
< 107	102	82 (80.39)	60 (58.82)	40 (39.22)
≥ 107	83	76 (91.57)	64 (77.11)	51 (61.45)
χ² value		8.531	6.389	5.421
P value		0.006	0.027	0.036