Jun
2019

The impact of pre-operative intravenous iron on quality of life after colorectal cancer surgery: outcomes from the intravenous iron in colorectal cancer-associated anaemia (IVICA) trial.

Keeler BD, Dickson EA, Simpson JA, et al.
Anaesthesia 2019;74:714-725.
NATA Rating :
Review by : M. Muñoz
NATA Review

In this follow-up of an open-label randomised controlled trial (designed to be pragmatic and applicable to current cancer treatment timelines, and powered to detect a difference in transfusion rates), the authors assessed the efficacy of intravenous ferric carboxymaltose (n = 42) vs. ferrous sulphate (n = 50), given at least two weeks preoperatively, in improving quality of life (QoL) in anaemic colorectal cancer patients.

Hb and QoL were assessed at recruitment, immediately before surgery and at three months postoperatively. The authors found that IV iron resulted in a faster clinically evident increase in QoL scores than oral iron and may be more effective in improving QoL scores in anaemic colorectal cancer surgical patients.

Despite its limitations, this study adds to the growing body of evidence indicating that the benefits of IV iron are not limited to the specific symptomatology of anaemia (through faster and greater rises in Hb) but are also evident across generic measures of well-being (which correlated with Hb levels and possibly with iron deficiency correction), with differences already observed on the day of surgery and increasing over the 3-month follow-up period. Therefore, IV iron supplementation may help achieve a balance between timely cancer treatment, Hb improvement and QoL.

– Manuel Muñoz