The association of ABO blood type with disease recurrence and mortality among patients with urothelial carcinoma of the bladder undergoing radical cystectomy

Boris Gershman, Daniel M. Moreira, Matthew K. Tollefson, Igor Frank, John C. Cheville, Prabin Thapa, Robert F. Tarrell, Robert H ouston Thompson, Stephen A. Boorjian

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

OBJECTIVES: To evaluate the association of ABO blood type with clinicopathologic outcomes and mortality among patients with urothelial carcinoma of the bladder treated with radical cystectomy (RC).

PATIENTS AND METHODS: We identified 2,086 consecutive patients who underwent RC between 1980 and 2008. Postoperative recurrence-free survival (RFS) and cancer-specific survival (CSS) were estimated using the Kaplan Meier method and compared with the log-rank test. Cox proportional hazards regression models were used to evaluate the association of ABO blood type with outcomes.

RESULTS: A total of 913 (44%), 881 (42%), 216 (10%), and 76 (4%) patients had blood type O, A, B, and AB, respectively. Median postoperative follow-up among survivors was 11.0 years (interquartile range: 7.7-15.9y). Overall, 1,561 patients died, with 770 deaths attributable to bladder cancer. Non-O blood type was associated with significantly worse 5-year RFS (65% vs. 69%; P = 0.04) and/or CSS (64% vs. 70%; P = 0.02). In particular, among patients with≤pT2N0 disease, the 5-year RFS for those with non-O vs. O blood type was 75% vs. 82%, respectively (P = 0.002), whereas the 5-year CSS was 77% vs. 85%, respectively (P = 0.001). Moreover, on multivariable analysis, blood type A remained independently associated with an increased risk of cancer-specific mortality (hazard ratio = 1.22; P = 0.01).

CONCLUSIONS: Non-O blood type, particularly blood type A, is associated with a significantly increased risk of death from bladder cancer among patients undergoing RC. If validated, the utility of a multimodal therapy approach, including perioperative chemotherapy, or more frequent postoperative surveillance in this cohort warrants further study.

Original languageEnglish (US)
JournalUrologic Oncology
Volume34
Issue number1
DOIs
StatePublished - Jan 1 2016

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Hematologic Diseases
Cystectomy
Urinary Bladder
Carcinoma
Recurrence
Mortality
Survival
Urinary Bladder Neoplasms
Neoplasms
Proportional Hazards Models
Survivors
Drug Therapy

Keywords

  • ABO
  • Bladder cancer
  • Blood type
  • Mortality
  • Survival

ASJC Scopus subject areas

  • Oncology
  • Urology

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The association of ABO blood type with disease recurrence and mortality among patients with urothelial carcinoma of the bladder undergoing radical cystectomy. / Gershman, Boris; Moreira, Daniel M.; Tollefson, Matthew K.; Frank, Igor; Cheville, John C.; Thapa, Prabin; Tarrell, Robert F.; Thompson, Robert H ouston; Boorjian, Stephen A.

In: Urologic Oncology, Vol. 34, No. 1, 01.01.2016.

Research output: Contribution to journalArticle

Gershman, Boris ; Moreira, Daniel M. ; Tollefson, Matthew K. ; Frank, Igor ; Cheville, John C. ; Thapa, Prabin ; Tarrell, Robert F. ; Thompson, Robert H ouston ; Boorjian, Stephen A. / The association of ABO blood type with disease recurrence and mortality among patients with urothelial carcinoma of the bladder undergoing radical cystectomy. In: Urologic Oncology. 2016 ; Vol. 34, No. 1.
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abstract = "OBJECTIVES: To evaluate the association of ABO blood type with clinicopathologic outcomes and mortality among patients with urothelial carcinoma of the bladder treated with radical cystectomy (RC).PATIENTS AND METHODS: We identified 2,086 consecutive patients who underwent RC between 1980 and 2008. Postoperative recurrence-free survival (RFS) and cancer-specific survival (CSS) were estimated using the Kaplan Meier method and compared with the log-rank test. Cox proportional hazards regression models were used to evaluate the association of ABO blood type with outcomes.RESULTS: A total of 913 (44{\%}), 881 (42{\%}), 216 (10{\%}), and 76 (4{\%}) patients had blood type O, A, B, and AB, respectively. Median postoperative follow-up among survivors was 11.0 years (interquartile range: 7.7-15.9y). Overall, 1,561 patients died, with 770 deaths attributable to bladder cancer. Non-O blood type was associated with significantly worse 5-year RFS (65{\%} vs. 69{\%}; P = 0.04) and/or CSS (64{\%} vs. 70{\%}; P = 0.02). In particular, among patients with≤pT2N0 disease, the 5-year RFS for those with non-O vs. O blood type was 75{\%} vs. 82{\%}, respectively (P = 0.002), whereas the 5-year CSS was 77{\%} vs. 85{\%}, respectively (P = 0.001). Moreover, on multivariable analysis, blood type A remained independently associated with an increased risk of cancer-specific mortality (hazard ratio = 1.22; P = 0.01).CONCLUSIONS: Non-O blood type, particularly blood type A, is associated with a significantly increased risk of death from bladder cancer among patients undergoing RC. If validated, the utility of a multimodal therapy approach, including perioperative chemotherapy, or more frequent postoperative surveillance in this cohort warrants further study.",
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T1 - The association of ABO blood type with disease recurrence and mortality among patients with urothelial carcinoma of the bladder undergoing radical cystectomy

AU - Gershman, Boris

AU - Moreira, Daniel M.

AU - Tollefson, Matthew K.

AU - Frank, Igor

AU - Cheville, John C.

AU - Thapa, Prabin

AU - Tarrell, Robert F.

AU - Thompson, Robert H ouston

AU - Boorjian, Stephen A.

PY - 2016/1/1

Y1 - 2016/1/1

N2 - OBJECTIVES: To evaluate the association of ABO blood type with clinicopathologic outcomes and mortality among patients with urothelial carcinoma of the bladder treated with radical cystectomy (RC).PATIENTS AND METHODS: We identified 2,086 consecutive patients who underwent RC between 1980 and 2008. Postoperative recurrence-free survival (RFS) and cancer-specific survival (CSS) were estimated using the Kaplan Meier method and compared with the log-rank test. Cox proportional hazards regression models were used to evaluate the association of ABO blood type with outcomes.RESULTS: A total of 913 (44%), 881 (42%), 216 (10%), and 76 (4%) patients had blood type O, A, B, and AB, respectively. Median postoperative follow-up among survivors was 11.0 years (interquartile range: 7.7-15.9y). Overall, 1,561 patients died, with 770 deaths attributable to bladder cancer. Non-O blood type was associated with significantly worse 5-year RFS (65% vs. 69%; P = 0.04) and/or CSS (64% vs. 70%; P = 0.02). In particular, among patients with≤pT2N0 disease, the 5-year RFS for those with non-O vs. O blood type was 75% vs. 82%, respectively (P = 0.002), whereas the 5-year CSS was 77% vs. 85%, respectively (P = 0.001). Moreover, on multivariable analysis, blood type A remained independently associated with an increased risk of cancer-specific mortality (hazard ratio = 1.22; P = 0.01).CONCLUSIONS: Non-O blood type, particularly blood type A, is associated with a significantly increased risk of death from bladder cancer among patients undergoing RC. If validated, the utility of a multimodal therapy approach, including perioperative chemotherapy, or more frequent postoperative surveillance in this cohort warrants further study.

AB - OBJECTIVES: To evaluate the association of ABO blood type with clinicopathologic outcomes and mortality among patients with urothelial carcinoma of the bladder treated with radical cystectomy (RC).PATIENTS AND METHODS: We identified 2,086 consecutive patients who underwent RC between 1980 and 2008. Postoperative recurrence-free survival (RFS) and cancer-specific survival (CSS) were estimated using the Kaplan Meier method and compared with the log-rank test. Cox proportional hazards regression models were used to evaluate the association of ABO blood type with outcomes.RESULTS: A total of 913 (44%), 881 (42%), 216 (10%), and 76 (4%) patients had blood type O, A, B, and AB, respectively. Median postoperative follow-up among survivors was 11.0 years (interquartile range: 7.7-15.9y). Overall, 1,561 patients died, with 770 deaths attributable to bladder cancer. Non-O blood type was associated with significantly worse 5-year RFS (65% vs. 69%; P = 0.04) and/or CSS (64% vs. 70%; P = 0.02). In particular, among patients with≤pT2N0 disease, the 5-year RFS for those with non-O vs. O blood type was 75% vs. 82%, respectively (P = 0.002), whereas the 5-year CSS was 77% vs. 85%, respectively (P = 0.001). Moreover, on multivariable analysis, blood type A remained independently associated with an increased risk of cancer-specific mortality (hazard ratio = 1.22; P = 0.01).CONCLUSIONS: Non-O blood type, particularly blood type A, is associated with a significantly increased risk of death from bladder cancer among patients undergoing RC. If validated, the utility of a multimodal therapy approach, including perioperative chemotherapy, or more frequent postoperative surveillance in this cohort warrants further study.

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KW - Bladder cancer

KW - Blood type

KW - Mortality

KW - Survival

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