OBJECTIVE - 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.
Clin Genitourin Cancer. 2015 May 4. pii: S1558-7673(15)00098-1. doi: 10.1016/j.clgc.2015.04.014. [Epub ahead of print]
Huang J1, Feldman AS2, Dong L1, Cornejo K3, Liu Q4, Dahl DM2, Wu S3, Blute ML2, Huang Y5, Wu CL6.
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. 6Department 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.