Perioperative intravenous ferric carboxymaltose improves anemia in patients with colorectal cancer: a propensity score–matched analysis

Background: Iron deficiency anemia (IDA) is common in patients with colorectal cancer and may negatively affect perioperative management. Although intravenous ferric carboxymaltose (FCM) has been shown to be effective for anemia correction, evidence regarding its perioperative clinical utility remains limited, particularly in Japan. Methods: We retrospectively analyzed patients with IDA who underwent elective colorectal cancer surgery between January 2020 and August 2023 at a single institution. Patients receiving a single preoperative dose of FCM (500 mg) were compared with those who did not receive FCM. Propensity score matching was applied to adjust for baseline differences. Hemoglobin (Hb) and mean corpuscular volume (MCV) were evaluated before surgery and postoperatively, along with perioperative transfusion, complications, and hospital stay. Results: After matching, 24 patients were included in each group. Hb levels were significantly higher in the FCM group immediately before surgery and 21 days postoperatively (p < 0.05). MCV levels were consistently higher in the FCM group at all postoperative time points. No significant differences were observed in perioperative transfusion rates, postoperative complications, or length of hospital stay. No FCM-related adverse events were reported. Conclusions: Preoperative intravenous FCM administration effectively improved perioperative hematological parameters in patients with colorectal cancer and IDA. Although short-term surgical outcomes were not significantly affected, intravenous iron supplementation represents a feasible strategy for optimizing perioperative anemia management in routine clinical practice.