Enderlin Dominik, Hertelendy Lea, Grogg Josias Bastian, von Stauffenberg Franz, Eberli Daniel, Poyet Cédric
Department of Urology, University Hospital of Zürich, 8091 Zürich, Switzerland.
Department of Urology, Stadtspital Triemli, 8063 Zürich, Switzerland.
Cancers (Basel). 2025 Aug 12;17(16):2633. doi: 10.3390/cancers17162633.
: Hemoglobin (Hb) has been identified to be an independent prognostic marker for oncological outcomes in several malignancies. However, the impact of Hb levels before radical prostatectomy (RP) in localized prostate cancer remains unclear. : Preoperative Hb levels were retrospectively collected from patients, who underwent RP from 2016 to 2022. Hb levels were analyzed as continuous and binary variables. For binary analysis, the cohort was divided into high-Hb (≥150 g/L) and low-Hb (<150 g/L) groups using the median as a cutoff. We used Spearman rank correlation to assess possible associations between Hb and continuous variables and logistic regression for Hb and binary variables. To assess the impact of preoperative Hb on recurrence-free survival (RFS), adjuvant treatment free survival (TFS), and metastasis-free survival (MFS), univariate and multivariate Cox regression analyses were performed. : A total of 567 patients were included in the analysis. Higher Hb levels, both when analyzed as a continuous variable and when divided in high and low groups, were inversely correlated with age ( < 0.001) and the International Society of Urological Pathology (ISUP) grade ( = 0.005 or = 0.028, respectively). Patients in the high-Hb group showed a decreased risk of extraprostatic disease (≥pT3) (odds ratio [OR] 0.71, 95%-CI: 0.50-0.99, = 0.047). In univariate cox regression analysis, high-Hb patients had a significantly longer RFS compared to the low-Hb group (hazard ratio [HR] 0.64, 95%-CI: 0.44-0.92, = 0.015). When adjusting for age, ISUP grade, positive surgical margin, prostate specific antigen, nodal status, and ≥pT3, this effect was no longer statistically significant (HR 0.76, 95%-CI 0.56-1.22, = 0.178). Hb was not a significant prognostic factor for TFS or MFS. : In this large cohort, lower preoperative Hb values were associated with a more aggressive tumor grading and shorter RFS. However, we were unable to identify Hb as an independent predictor of oncological survival outcomes.
血红蛋白（Hb）已被确定为几种恶性肿瘤肿瘤学预后的独立预测标志物。然而，局限性前列腺癌根治性前列腺切除术（RP）前Hb水平的影响仍不清楚。
回顾性收集了2016年至2022年接受RP治疗患者的术前Hb水平。Hb水平作为连续变量和二元变量进行分析。对于二元分析，以中位数为临界值将队列分为高Hb（≥150g/L）和低Hb（<150g/L）组。我们使用Spearman等级相关性评估Hb与连续变量之间的可能关联，使用逻辑回归评估Hb与二元变量之间的关联。为了评估术前Hb对无复发生存期（RFS）、无辅助治疗生存期（TFS）和无转移生存期（MFS）的影响，进行了单因素和多因素Cox回归分析。
共有567例患者纳入分析。当作为连续变量分析以及分为高低组时，较高的Hb水平均与年龄呈负相关（<0.001）以及与国际泌尿病理学会（ISUP）分级呈负相关（分别为=0.005或=0.028）。高Hb组患者前列腺外疾病（≥pT3）风险降低（比值比[OR]0.71，95%可信区间：0.50 - 0.99，=0.047）。在单因素Cox回归分析中，高Hb患者与低Hb组相比RFS显著更长（风险比[HR]0.64，95%可信区间：0.44 - 0.92，=0.015）。在调整年龄、ISUP分级、手术切缘阳性、前列腺特异性抗原、淋巴结状态和≥pT3后，这种效应不再具有统计学意义（HR 0.76，95%可信区间0.56 - 1.22，=0.178）。Hb不是TFS或MFS的显著预后因素。
在这个大型队列中，术前较低的Hb值与更具侵袭性的肿瘤分级和较短的RFS相关。然而，我们无法将Hb确定为肿瘤学生存结果的独立预测指标。
