Jiwei Huang1, Adam S Feldman2, Liang Dong1, Kristine Cornejo3, Qiang Liu4, Douglas M Dahl2, Shulin Wu3, Michael L Blute2, Yiran Huang5, Chin-Lee Wu6. 1. Department of Urology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China. 2. Department of Urology, Massachusetts General Hospital and Harvard Medical School, Boston, MA. 3. Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA. 4. Department of Pathology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China. 5. Department of Urology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China. Electronic address: yrhuangrenji@163.com. 6. Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA; Department of Pathology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China. Electronic address: cwu2@partners.org.
Abstract
OBJECTIVES: Preoperative anemia has been proposed as a prognostic factor for clear cell renal cell carcinoma. We evaluate its role in papillary renal cell carcinoma (pRCC). METHODS: At 2 institutions, patients who underwent complete resection of localized (T1-3 N0/+ M0) pRCC by radical or partial nephrectomy were retrospectively reviewed in this study. Anemia was defined as hemoglobin < 13.5 g/dL in men and < 12 g/dL in women. The associations of preoperative anemia with clinical and pathologic variables were assessed using the Student t, Wilcoxon rank-sum, and chi-square tests. Univariable and multivariable analyses using the Kaplan-Meier method and the Cox regression model were performed to determine factors that were associated with recurrence-free survival (RFS), cancer-specific survival (CSS), and overall survival (OS). RESULTS: Our final cohort included 352 patients. Compared with patients without anemia, patients with anemia were older and more likely to have larger tumor size and higher Fuhrman grade. Kaplan-Meier curves showed that patients with preoperative anemia had significantly worse RFS, CSS, and OS than patients without anemia (log-rank test, all P < .001). Multivariable analyses revealed that anemia was an independent prognostic factor in terms of RFS, CSS, and OS (all P < .001). CONCLUSIONS: Preoperative anemia is an important independent prognostic factor associated with an increased risk of recurrence and mortality in patients after surgery with a curative intent for localized pRCC. Consideration of preoperative anemia could provide urologists additional prognostic information in patients with pRCC.
OBJECTIVES:Preoperative anemia has been proposed as a prognostic factor for clear cell renal cell carcinoma. We evaluate its role in papillary renal cell carcinoma (pRCC). METHODS: At 2 institutions, patients who underwent complete resection of localized (T1-3 N0/+ M0) pRCC by radical or partial nephrectomy were retrospectively reviewed in this study. Anemia was defined as hemoglobin < 13.5 g/dL in men and < 12 g/dL in women. The associations of preoperative anemia with clinical and pathologic variables were assessed using the Student t, Wilcoxon rank-sum, and chi-square tests. Univariable and multivariable analyses using the Kaplan-Meier method and the Cox regression model were performed to determine factors that were associated with recurrence-free survival (RFS), cancer-specific survival (CSS), and overall survival (OS). RESULTS: Our final cohort included 352 patients. Compared with patients without anemia, patients with anemia were older and more likely to have larger tumor size and higher Fuhrman grade. Kaplan-Meier curves showed that patients with preoperative anemia had significantly worse RFS, CSS, and OS than patients without anemia (log-rank test, all P < .001). Multivariable analyses revealed that anemia was an independent prognostic factor in terms of RFS, CSS, and OS (all P < .001). CONCLUSIONS:Preoperative anemia is an important independent prognostic factor associated with an increased risk of recurrence and mortality in patients after surgery with a curative intent for localized pRCC. Consideration of preoperative anemia could provide urologists additional prognostic information in patients with pRCC.
Authors: Jung Ki Jo; Seong Jin Jeong; Sung Kyu Hong; Seok-Soo Byun; Sang Eun Lee; Jong Jin Oh Journal: Int Urol Nephrol Date: 2016-01-25 Impact factor: 2.370