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2022-RA-850-ESGO Iron prehabilitation in endometrial cancer patients waiting for surgery: a feasibility pilot study
  1. Eleftherios Zachariou,
  2. Vasilios Pergialiotis,
  3. Ioakim Sapantzoglou,
  4. Ioannis Prokopakis,
  5. Dimitrios Haidopoulos,
  6. Alexandros Rodolakis and
  7. Nikolaos Thomakos
  1. 1st Department of Obstetrics and Gynecology, Alexandra hospital, Athens, Greece


Introduction/Background Surgical lists for cancer treatment steadily increase the last decade as more patients seek treatment in referral centers. During this time, red blood cell parameters are altered in endometrial cancer patients that bleed. Anemia has been previously correlated with increased risk of perioperative transfusion and with increased risk of perioperative infection. The latter may lead to increased intervals to adjuvant treatment which, subsequently, can affect survival rates.

Methodology In the present pilot study we assessed patient acceptance and adherence to an iron prehabilitation program as well as differences in red blood cell parameters during this period.

Results Overall, 35 patients were enrolled in the present study of whom, 20 received iron prehabilitation at a dose of 300 mg twice a day for a mean period of 45 days. Adherence to the protocol was monitored by phone calls at 15 day intervals until the pre-operative admission to the hospital during which the packages of iron were inspected to evaluate the absolute number of intake. Preoperatively, we observed that red blood cell parameters significantly changed in both groups. Specifically, patients that received iron had significant improvement during the interval to surgical treatment (p=.029), whereas patients that did not receive iron supplementation had significant decrease in their blood parameters (p=.011). Transfusion rates during the perioperative period were reduced in the transfusion group, however, the result did not reach the appropriate level of statistical significance (p=.294) which can be attributed to the relatively small sample size.

Conclusion Iron prehabilitation is feasible during the preoperative period in endometrial cancer patients as it is accompanied by high acceptance rates. Moreover, it increases significantly red blood cell parameters and may be accompanied by significantly reduced number of perioperative transfusions, although larger studies are needed to corroborate our findings.

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