» Articles » PMID: 25832016

Preoperative Anemia is Associated with Adverse Outcome in Patients with Urothelial Carcinoma of the Bladder Following Radical Cystectomy

Overview
Specialty Oncology
Date 2015 Apr 3
PMID 25832016
Citations 20
Authors
Affiliations
Soon will be listed here.
Abstract

Purpose: Radical cystectomy (RC) can be associated with significant blood loss, whereas many patients are presenting with anemia preoperatively. To date, there is a lack of data addressing the impact of preoperative anemia (PA) on survival of patients undergoing RC for urothelial carcinoma of the bladder (UCB).

Methods: This retrospective multicenter study includes 684 patients with UCB undergoing RC with pelvic lymph node dissection. The median follow-up was 50 (IQR 29,78) months. Anemia was defined in line with the WHO classification (hemoglobin (Hb): male ≤13 g/dL, female ≤12 g/dL) and based on contemporary gender- and age-adjusted classification (Hb: white male aged <60 years: ≤13.7 g/dL; ≥60 years: ≤13.2 g/dL; white female of all ages ≤12.2 g/dL). Univariable and multivariable Cox regression analyses were used to assess the effects of PA on oncological outcomes.

Results: A total of 269 (39.3 %) and 302 (44.2 %) patients were anemic according to the WHO classification versus contemporary classification. Age, increased ECOG performance status, advanced tumor stages, lymph node metastasis, positive surgical margin and anemia were associated with disease recurrence (DR), cancer-specific mortality (CSM) and all-cause mortality (ACM). In multivariable analysis, anemia was an independent predictor of DR, CSM and ACM (WHO and/or contemporary classification). Blood transfusion was significantly associated with ACM in both classifications of anemia.

Conclusions: PA is significantly associated with worse oncological outcome in patients undergoing RC. Based on the additional unfavorable influence of blood transfusion, this emphasizes the importance of early diagnosis and correction of anemia and implementation of alternative methods of blood volume management.

Citing Articles

Updates on enhanced recovery after surgery for radical cystectomy.

Lee G, Patel H, Srivastava A, Ghodoussipour S Ther Adv Urol. 2022; 14:17562872221109022.

PMID: 35844831 PMC: 9280843. DOI: 10.1177/17562872221109022.


Prognostic Value of the Combination of HB (hemoglobin) and CEA in Resectable Gastric Cancer.

Qiu X, Shen C, Zhao W, Zhang X, Zhao D, Zhu Y J Cancer. 2022; 13(7):2246-2257.

PMID: 35517424 PMC: 9066204. DOI: 10.7150/jca.67600.


The prognostic impact of pretreatment anemia in patients with gastric cancer and nonhypoalbuminemia undergoing curative resection: a retrospective study.

Jiang J, Ouyang J, Liu S, Chen J, Zhang H, Wang C Ann Transl Med. 2021; 9(13):1046.

PMID: 34422958 PMC: 8339834. DOI: 10.21037/atm-21-1649.


Prognostic impact of perioperative blood transfusions on oncological outcomes of patients with bladder cancer undergoing radical cystectomy: A systematic review.

Volz Y, Eismann L, Pfitzinger P, Jokisch J, Buchner A, Schlenker B Arab J Urol. 2021; 19(1):24-30.

PMID: 33763245 PMC: 7954477. DOI: 10.1080/2090598X.2020.1859055.


Prognostic value of preoperative hematologic biomarkers in urothelial carcinoma of the bladder treated with radical cystectomy: a systematic review and meta-analysis.

Mori K, Miura N, Mostafaei H, Quhal F, Sari Motlagh R, Lysenko I Int J Clin Oncol. 2020; 25(8):1459-1474.

PMID: 32451768 PMC: 7392936. DOI: 10.1007/s10147-020-01690-1.


References
1.
Mayr R, May M, Martini T, Lodde M, Pycha A, Comploj E . Predictive capacity of four comorbidity indices estimating perioperative mortality after radical cystectomy for urothelial carcinoma of the bladder. BJU Int. 2012; 110(6 Pt B):E222-7. DOI: 10.1111/j.1464-410X.2012.10938.x. View

2.
Burger M, Catto J, Dalbagni G, Grossman H, Herr H, Karakiewicz P . Epidemiology and risk factors of urothelial bladder cancer. Eur Urol. 2012; 63(2):234-41. DOI: 10.1016/j.eururo.2012.07.033. View

3.
Wigren T . Confirmation of a prognostic index for patients with inoperable non-small cell lung cancer. Radiother Oncol. 1997; 44(1):9-15. DOI: 10.1016/s0167-8140(97)00087-x. View

4.
DeFoe G, Ross C, Olmstead E, Surgenor S, Fillinger M, Groom R . Lowest hematocrit on bypass and adverse outcomes associated with coronary artery bypass grafting. Northern New England Cardiovascular Disease Study Group. Ann Thorac Surg. 2001; 71(3):769-76. DOI: 10.1016/s0003-4975(00)02393-6. View

5.
Harrell Jr F, Lee K, Mark D . Multivariable prognostic models: issues in developing models, evaluating assumptions and adequacy, and measuring and reducing errors. Stat Med. 1996; 15(4):361-87. DOI: 10.1002/(SICI)1097-0258(19960229)15:4<361::AID-SIM168>3.0.CO;2-4. View