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ABO血型对接受根治性膀胱切除术治疗的膀胱尿路上皮癌患者死亡率的影响。

Effect of ABO blood type on mortality in patients with urothelial carcinoma of the bladder treated with radical cystectomy.

作者信息

Klatte Tobias, Xylinas Evanguelos, Rieken Malte, Rouprêt Morgan, Fajkovic Harun, Seitz Christian, Karakiewicz Pierre I, Lotan Yair, Babjuk Marko, de Martino Michela, Shariat Shahrokh F

机构信息

Department of Urology, Medical University of Vienna, Vienna General Hospital, Vienna, Austria.

Department of Urology, Weill Cornell Medical College, Presbyterian Hospital, New York, NY; Department of Urology, Cochin Hospital, APHP, Paris Descartes University, Paris, France.

出版信息

Urol Oncol. 2014 Jul;32(5):625-30. doi: 10.1016/j.urolonc.2013.11.010. Epub 2014 Feb 2.

Abstract

OBJECTIVE

ABO blood type is an inherited characteristic that has been associated with the prognosis of several malignancies, but there is little evidence in urothelial carcinoma of the bladder (UCB). The purpose of this study was to evaluate the effect of ABO blood type on mortality in patients with UCB treated with radical cystectomy (RC).

METHODS

Multi-institutional data from 7,906 patients with UCB treated with RC between 1979 and 2012 were retrospectively analyzed. The effect of ABO blood type on UCB-related mortality was evaluated with univariable and multivariable competing-risks regression models.

RESULTS

ABO blood type was O in 3,728 (47%), A in 2,748 (35%), B in 888 (11%), and AB in 532 (7%) patients. Blood type B was associated with a greater likelihood of lymphovascular invasion (P = 0.010) and positive soft tissue margins (P = 0.008). The median follow-up was 41 months. The 5-year cumulative UCB-related mortality rates for blood type O, A, B, and AB were 29.5%, 30.5%, 33.2%, and 25.8%, respectively. In univariable competing-risks regression, patients with blood type B had worse UCB-related mortality than those with blood type O (P = 0.026) and AB (P = 0.020). In multivariable analysis, however, blood type lost its statistical significance.

CONCLUSIONS

Among patients treated with RC, ABO blood type is associated with a statistically significant but clinically insignificant difference in UCB-related mortality. This association was not present in multivariable analysis. Our data therefore suggest no relevant association of ABO blood type with UCB-related prognosis.

摘要

目的

ABO血型是一种遗传特征,已被证明与多种恶性肿瘤的预后相关,但在膀胱尿路上皮癌(UCB)中证据较少。本研究旨在评估ABO血型对接受根治性膀胱切除术(RC)治疗的UCB患者死亡率的影响。

方法

回顾性分析了1979年至2012年间7906例接受RC治疗的UCB患者的多机构数据。采用单变量和多变量竞争风险回归模型评估ABO血型对UCB相关死亡率的影响。

结果

3728例(47%)患者血型为O,2748例(35%)为A,888例(11%)为B,532例(7%)为AB。血型B与淋巴管侵犯(P = 0.010)和软组织切缘阳性(P = 0.008)的可能性更大相关。中位随访时间为41个月。血型O、A、B和AB的5年累积UCB相关死亡率分别为29.5%、30.5%、33.2%和25.8%。在单变量竞争风险回归中,血型为B的患者UCB相关死亡率比血型为O(P = 0.026)和AB(P = 0.020)的患者更差。然而,在多变量分析中,血型失去了统计学意义。

结论

在接受RC治疗的患者中,ABO血型与UCB相关死亡率存在统计学上显著但临床上无显著意义的差异。这种关联在多变量分析中不存在。因此,我们的数据表明ABO血型与UCB相关预后无相关关联。

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