ABO blood group is a predictor of survival in patients undergoing surgery for renal cell carcinoma

Authors


Samuel D. Kaffenberger, Department of Urologic Surgery, Vanderbilt University Medical Center, A1302 Medical Center North, Nashville, TN 37215, USA. e-mail: samuel.d.kaffenberger@vanderbilt.edu

Abstract

Study Type – Prognosis (cohort series)

Level of Evidence 3a

What's known on the subject? and What does the study add?

Some evidence suggests that ABO blood type may be a risk factor for cancer incidence and prognosis. For example, a large study recently discovered an increased incidence of pancreatic cancer in patients with non-O blood type; however, it is not known whether blood group correlates with outcomes in patients with RCC.

We found a significant and independent association between ABO blood group and overall survival in patients undergoing surgery for locoregional RCC. Specifically, we identified non-O blood type as a predictor of mortality.

OBJECTIVE

  • • To determine whether ABO blood group is associated with survival after nephrectomy or partial nephrectomy for renal cell carcinoma (RCC).

PATIENTS AND METHODS

  • • We conducted a retrospective cohort study of 900 patients who underwent surgery for locoregional RCC between 1997 and 2008 at a single institution.
  • • Covariates included age, gender, race, American Society of Anesthesiology Physical Status, preoperative anaemia and hypoalbuminemia, tumour characteristics, lymph node status, procedure performed, transfusion status and ABO blood group.
  • • Primary outcomes were overall (OS) and disease-specific survival (DSS).
  • • Univariable survival analyses were performed using the Kaplan–Meier and log-rank methods. Multivariable analysis was performed using a Cox proportional hazards model.

RESULTS

  • • The 3-year OS estimate was 75% (95%CI 70–79%) for O blood group and 68% (95% CI 63–73%) for non-O blood group (P= 0.072). The 3-year DSS was 81% (95% CI 76–85%) for O blood group and 76% (95%CI 71–80%) for non-O blood group (P= 0.053).
  • • In the multivariable analysis for OS, non-O blood type was significantly associated with decreased OS (HR 1.68, 95%CI 1.18–2.39; P= 0.004) but not DSS (HR 1.53, 95%CI 0.97–2.41; P= 0.065).

CONCLUSION

  • • These data suggest that ABO blood group is independently associated with OS in patients undergoing surgery for locoregional RCC. ABO blood group has not been previously recognized as a predictor of survival in RCC.

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