Background/Objectives: Colorectal cancer (CRC) is among the most commonly reported malignancies globally, taking the third place in incidence among males as well as the second among females, with over 1.9 million new cases and 935,000 deaths estimated worldwide in 2020. One of the most common and clinically significant comorbidities in patients undergoing CRC surgery is preoperative anemia, with reported prevalence ranging from 23% to over 60% depending on the population and diagnostic criteria used. The objective of the current study is to systematically evaluate the current body of evidence on preoperative anemia management in adults undergoing surgery for non-metastatic CRC. This review aims to assess the clinical impact of different iron supplementation strategies, particularly IV versus oral iron in pre-operative hematologic optimization, transfusion requirements, postoperative complications, and recovery outcomes. Methods: The current systematic review was conducted based on the PRISMA for Systematic Reviews and Meta-analysis checklist. The study has been registered to PROSPERO with the ID CRD420251113455. Results: Across all studies, IV iron and erythropoiesis-stimulating agents emerged as safe and more efficient alternatives to iron per os, especially when initiated at least two weeks before surgery. Thus, highlighting the clinical value of proactive anemia management as a cornerstone of surgical prehabilitation, potentially reducing transfusion burden and improving recovery outcomes for CRC patients. Conclusions: It is observed that IV iron therapy offers a more effective strategy than per os supplementation for correcting preoperative anemia in non-metastatic colorectal cancer patients. Their hematologic benefits enhance surgical readiness and reduce postoperative intervention needs. Thus, supporting the integration of IV iron into preoperative optimization protocols.
背景/目的：结直肠癌是全球最常见的恶性肿瘤之一，在男性中发病率位居第三，在女性中位居第二，2020年全球估计新增病例超过190万例，死亡93.5万例。接受结直肠癌手术的患者中最常见且具有重要临床意义的合并症之一是术前贫血，根据研究人群和诊断标准的不同，其患病率报告在23%至60%以上。本研究旨在系统评估目前关于非转移性结直肠癌手术成人患者术前贫血管理的证据。本综述旨在评估不同补铁策略（特别是静脉补铁与口服补铁）在术前血液学优化、输血需求、术后并发症及康复结局方面的临床影响。方法：本系统综述依据PRISMA系统综述和荟萃分析清单进行。研究已在PROSPERO注册，编号为CRD420251113455。结果：在所有研究中，静脉补铁和促红细胞生成药物相较于口服补铁显示出更安全、更有效的优势，尤其是在术前至少两周开始使用时。这突显了主动管理贫血作为外科预康复基石的临床价值，可能减轻结直肠癌患者的输血负担并改善康复结局。结论：研究发现，对于非转移性结直肠癌患者术前贫血的纠正，静脉补铁疗法比口服补铁提供了更有效的策略。其血液学益处有助于提升手术准备度并减少术后干预需求。因此，支持将静脉补铁纳入术前优化方案。
肿瘤(癌症)患者之家