AB0 blood groups and oncological and functional outcomes in bladder cancer patients treated with radical cystectomy


https://doi.org/10.4081/aiua.2022.4.428
Vol. 94 No. 4 (2022)
Submitted: September 21, 2022
Accepted: October 2, 2022
Published: December 27, 2022
ABO, Blood groups, Bladder Cancer, Radical Cystectomy, Outcomes
Abstract Views: 528
PDF: 252
Supplementary Material: 40
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Authors

  • Alessandro Tafuri
    aletaf@hotmail.it
    Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Italy; Department of Urology, “Vito Fazzi” Hospital, Lecce, Italy.
  • Andrea Panunzio Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Italy; Cancer and Prognostics Health Outcomes Unit, Division of Urology, University of Montreal Health Center, Montreal, Quebec, Canada.
  • Antonio Soldano Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Italy.
  • Giovanni Mazzucato Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Italy.
  • Paola Irene Ornaghi Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Italy.
  • Giacomo Di Filippo Department of General and Hepatobiliary Surgery, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy.
  • Alessandra Gozzo Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Italy.
  • Nicola De Maria Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Italy.
  • Francesco Cianflone Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Italy.
  • Aliasger Shakir USC Institute of Urology, Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California (USC), Los Angeles, United States.
  • Zhe Tian Cancer and Prognostics Health Outcomes Unit, Division of Urology, University of Montreal Health Center, Montreal, Quebec, Canada.
  • Matteo Brunelli Department of Pathology, University of Verona, Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Italy.
  • Antonio Benito Porcaro Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Italy.
  • Vincenzo Pagliarulo Department of Urology, “Vito Fazzi” Hospital, Lecce, Italy.
  • Walter Artibani Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Italy.
  • Pierre I. Karakiewicz Cancer and Prognostics Health Outcomes Unit, Division of Urology, University of Montreal Health Center, Montreal, Quebec, Canada.
  • Alessandro Antonelli Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Italy.
  • Maria Angela Cerruto Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Italy.

Objectives: We investigated AB0 blood groups prevalence according to preoperative and pathological tumor characteristics, and their association with oncological outcomes, and renal function decline in a contemporary large cohort of bladder cancer (BCa) patients, who underwent radical cystectomy (RC) at a tertiary referral center.
Materials and Methods: We retrospectively evaluated data of patients with histologically confirmed and clinically non metastatic BCa, who underwent RC between 2014 and 2021 at our Institution. Kaplan-Meier (KM) plots and Cox regression (CR) models tested the relationship between AB0 blood groups and local recurrence-, metastasis-, cancer specific mortality-, and overall mortality-free survival. Logistic regression (LR) models tested the association between AB0 blood groups and renal function decline, defined as an estimated Glomerular Filtration Rate (eGFR) < 60 mL/min, at post-operative day 1, discharge and 6- months of follow-up.
Results: Of 301 included patients, 128 (42.5%) had group A, 126 (41.9%) had group 0, 28 (9.3%) had group B, and 19 (6.3%) had group AB. Patients with group 0 developed higher rates of muscle- invasive BCa (p = 0.028) with high-grade features (p = 0.005) at last bladder resection, and less frequently received preoperative immunotherapy with Bacillus of Calmette-Guerin (p = 0.044), than their non-0 counterparts. Additionally, these patients harbored more advanced pathologic tumor stage at RC (p = 0.024). KM plots showed no differences among all tested cancer control outcomes between AB0 blood groups (p > 0.05 in all cases). Patients with group AB presented the lowest median eGFR at each time point. In multivariable LR analyses addressing renal function decline, group AB was independently associated with eGFR< 60 mL/min at discharge (Odds Ratio: 4.28, p = 0.047).
Conclusions: Among AB0 blood groups, patients with group 0 exhibited the most aggressive tumor profile. However, no differences were recorded in recurrence or survival rates. Group AB independently predicted renal function decline at discharge.


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Tafuri, A., Panunzio, A., Soldano, A., Mazzucato, G., Ornaghi, P. I., Di Filippo, G., Gozzo, A., De Maria, N., Cianflone, F., Shakir, A., Tian, Z., Brunelli, M., Porcaro, A. B., Pagliarulo, V., Artibani, W., Karakiewicz, P. I., Antonelli, A., & Cerruto, M. A. (2022). AB0 blood groups and oncological and functional outcomes in bladder cancer patients treated with radical cystectomy. Archivio Italiano Di Urologia E Andrologia, 94(4), 428–433. https://doi.org/10.4081/aiua.2022.4.428

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