The authors assessed whether FeSO4 supplementation (median of 39 days) impacted significantly on preoperative hemoglobin (Hb) levels and transfusion requirements in 103 patients undergoing surgery for colorectal cancer.

They found that oral iron treatment led to an increase in Hb levels and a reduction
in transfusion requirements (in comparison to a historical cohort), and that anemic patients and those with right-sided lesions benefited the most.

While the results are promising, the study presents several limitations that make it difficult to draw conclusions: 1) comparison to a historical cohort; 2) no laboratory parameters of iron status or inflammation; 3) no postoperative Hb data; 4) transfusion rates (percentage of patients transfused) or
transfusion index (units per transfused patient) not provided; 5) no comparison of transfusion rates between anemic and non-anemic patients;
6) no comparison of transfusion or Hb data between short-course (up to 14 days) and longer-course (more than 14 days) iron supplementation.

Therefore, randomized controlled trials comparing no intervention with oral and/or intravenous iron in colorectal cancer patients are urgently needed.

– Manuel Muoz