D'Andrea David, Moschini Marco, Soria Francesco, Gust Kilian M, Briganti Alberto, Karakiewicz Pierre I, Rouprêt Morgan, Shariat Shahrokh F
Department of Urology, Medical University of Vienna, Vienna, Austria.
Urological Research Institute, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy.
Anticancer Res. 2017 Oct;37(10):5747-5753. doi: 10.21873/anticanres.12014.
To investigate the role of ABO blood group and Rhesus factor as a predictor of outcome in patients undergoing radical cystectomy (RC) for non-metastatic urothelial carcinoma of the bladder.
Data of 463 consecutive patients treated with RC between 1988 and 2003 were retrospectively analyzed. The effect on recurrence-free survival, and cancer-specific and overall mortality were assessed using the Kaplan-Meier and multivariable Cox regression methods.
Overall, 185 (41.3%), 190 (42.4%), 46 (10.3%) and 27 (6%) patients expressed O, A, B and AB phenotypes, respectively; 65 (14.5%) were Rhesus-negative. Median follow-up was 14.2 years (interquartile range=10.2-17.1 years). No individual blood group was associated with any clinicopathological characteristics whereas Rhesus-positive patients had a higher rate of pT4 disease (11% vs. 22%; p=0.02). ABO blood groups were not associated with outcomes. Rhesus-positive patients had an increased risk of shorter recurrence-free survival, and of cancer-specific and overall mortality compared to Rhesus-negative patients (all p<0.03). In multivariable analyses that adjusted for the effects of standard characteristics, this association disappeared.
The results of our study showed that neither ABO blood group nor Rhesus factor are associated with oncological outcomes. The clinical relevance of blood groups and Rhesus factor in bladder cancer remains questionable.
探讨ABO血型和恒河猴因子作为非转移性膀胱尿路上皮癌患者根治性膀胱切除术(RC)预后预测指标的作用。
回顾性分析1988年至2003年间连续接受RC治疗的463例患者的数据。采用Kaplan-Meier法和多变量Cox回归法评估对无复发生存率、癌症特异性死亡率和总死亡率的影响。
总体而言,分别有185例(41.3%)、190例(42.4%)、46例(10.3%)和27例(6%)患者表现为O、A、B和AB血型;65例(14.5%)为恒河猴阴性。中位随访时间为14.2年(四分位间距=10.2 - 17.1年)。单个血型与任何临床病理特征均无关联,而恒河猴阳性患者的pT4疾病发生率较高(11%对22%;p = 0.02)。ABO血型与预后无关。与恒河猴阴性患者相比,恒河猴阳性患者无复发生存期缩短、癌症特异性死亡率和总死亡率增加的风险更高(所有p < 0.03)。在对标准特征的影响进行校正的多变量分析中,这种关联消失。
我们的研究结果表明,ABO血型和恒河猴因子均与肿瘤学预后无关。血型和恒河猴因子在膀胱癌中的临床相关性仍存在疑问。