Gözde AĞDAŞ, Mehmet Salim DEMİR
Anatolian Current Medical Journal - 2026;8(1):71-76
Aims: The aim of this study was to evaluate the impact of anemia at the time of recurrence on survival and prognosis in patients with esophageal squamous cell carcinoma (ESCC) who developed relapse during follow-up after definitive treatment. Methods: The data of 105 patients who had received definitive treatment for ESCC and subsequently developed recurrence were retrospectively reviewed. The mean age of the patients was 62.1+/-5.9 years (median 62), and 68.6% were male. Based on hemoglobin levels at the time of recurrence, patients were categorized into anemia and non-anemia groups according to laboratory reference ranges. Clinical characteristics, recurrence patterns, and treatments administered for recurrence were compared between the groups. Survival analyses were performed using the Kaplan-Meier method and the log-rank test; factors affecting post-recurrence mortality were evaluated with Cox regression analysis. Results: Anemia was detected in 60.0% of patients at the time of recurrence. Patients with anemia were significantly older than those without anemia (64.7+/-4.9 vs. 58.3+/-5.5 years, p<0.001) and more frequently had advanced disease at the initial diagnosis (stage III-IV: 93.6% vs. 19.0%, p<0.001). Most recurrences in the anemia group were distant metastatic or combined patterns, whereas 88.1% of the non-anemic group presented with localized recurrence (p<0.001). Post-recurrence survival was markedly worse in the anemic group: the mortality rate was 93.7% compared to 64.3% in the non-anemic group (p<001). However, in multivariate analysis, anemia was not an independent prognostic factor for mortality (p=0.149). Distant recurrence type (HR: 0.554, p=0.033) and palliative CT/RT as recurrence treatment (HR: 3.441, p<0.001) were identified as independent predictors. Conclusion: Although anemia at the time of recurrence in patients with esophageal cancer was not an independent prognostic factor, it is a prevalent finding that reflects more advanced disease and poorer survival outcomes. It may serve as a clinical marker of systemic inflammation and high tumor burden, helping to identify a patient subgroup with a worse prognosis.
