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Patients with urothelial carcinoma of the bladder undergoing radical cystectomy: non-O blood type, specifically type A, was associated with increased risk of bladder cancer death


Researchers have evaluated the association of ABO blood type with clinicopathologic outcomes and mortality among patients with urothelial carcinoma of the bladder treated with radical cystectomy.

2,086 consecutive patients who underwent radical cystectomy between 1980 and 2008 were identified.

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: 7.7–15.9 years ).

Overall, 1,561 patients died, with 770 deaths attributable to bladder cancer.

Non-O blood type was associated with significantly worse 5-year recurrence-free survival ( 65% vs 69%; P = 0.04 ) and/or cancer-specific survival ( 64% vs 70%; P = 0.02 ).

In particular, among patients with greater than or equal to pT2N0 disease, the 5-year recurrence-free survival for those with non-O vs O blood type was 75% vs 82%, respectively ( P = 0.002 ), whereas the 5-year cause-specific survival ( 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, HR=1.22; P = 0.01 ).

In conclusion, non-O blood type, particularly blood type A, is associated with a significantly increased risk of death from bladder cancer among patients undergoing radical cystectomy.
If validated, the utility of a multimodal therapy approach, including perioperative chemotherapy, or more frequent postoperative surveillance in this cohort warrants further study. ( Xagena )

Gershman B et al, Urol Oncol 2016; 34, 4.e1–4.e9

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