title: Impact of ABO blood type on outcomes in patients with primary nonmuscle invasive bladder cancer.
abstract: OBJECTIVE
  ABO blood type is an established prognostic factor for several malignancies but its role in bladder urothelial carcinoma is largely unknown. We determined whether ABO blood type is associated with the outcome of transurethral resection of nonmuscle invasive bladder urothelial carcinoma.
  
  
  METHODS
  We retrospectively studied ABO blood types in 931 patients with primary nonmuscle invasive bladder urothelial carcinoma treated with transurethral bladder resection with or without intravesical instillation therapy. Disease recurrence and progression were analyzed with univariable and multivariable competing risks regression models. Median followup was 67 months. Discrimination was evaluated by the concordance index.
  
  
  RESULTS
  The ABO blood type was O, A, B and AB in 414 (44.5%), 360 (38.7%), 103 (11.1%) and 54 patients (5.8%), respectively. ABO blood type was significantly associated with outcome on univariable and multivariable analysis. Overall, patients with blood type O had worse recurrence and progression rates than those with A (p = 0.015 and 0.031) or B (p = 0.004 and 0.075, respectively). The concordance index of multivariable base models increased after including ABO blood type.
  
  
  CONCLUSIONS
  In patients with nonmuscle invasive bladder urothelial carcinoma the ABO blood type may predict the outcome. Those with blood type O showed the highest recurrence and progression rates. Including ABO blood type in multivariable models increases the accuracy of standard prognostic factors. Since the ABO blood type is available for most patients, it may represent an ideal adjunctive marker to predict recurrence and progression. The biological explanation and prognostic value of this finding must be further elucidated.
authors: Department of Urology, Medical University of Vienna, Vienna General Hospital, Vienna, Austria.
authors: Tobias
authors: T
authors: Klatte
authors: Department of Urology, Weill Cornell Medical College, New York-Presbyterian Hospital, New York, New York; Department of Urology, Cochin Hospital, Assistance Publique Hopitaux de Paris, Paris Descartes University, Paris, France.
authors: Evanguelos
authors: E
authors: Xylinas
authors: Department of Urology, Weill Cornell Medical College, New York-Presbyterian Hospital, New York, New York.
authors: Malte
authors: M
authors: Rieken
authors: Department of Urology, Weill Cornell Medical College, New York-Presbyterian Hospital, New York, New York; Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors: Luis A
authors: LA
authors: Kluth
authors: Department of Urology, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique Hopitaux de Paris, Faculty of Medicine Pierre et Marie Curie, Institut Universitaire de Cancérologie GRC5, University Paris 6, Paris, France; Department of Urology, University Hospital Basel, Basel, Switzerland.
authors: Morgan
authors: M
authors: Rouprêt
authors: Department of Urology, Central Hospital of Bolzano, Bolzano, Italy.
authors: Armin
authors: A
authors: Pycha
authors: Department of Urology, Medical University of Vienna, Vienna General Hospital, Vienna, Austria.
authors: Harun
authors: H
authors: Fajkovic
authors: Department of Urology, Medical University of Vienna, Vienna General Hospital, Vienna, Austria.
authors: Christian
authors: C
authors: Seitz
authors: Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Centre, Montreal, Quebec, Canada.
authors: Pierre I
authors: PI
authors: Karakiewicz
authors: Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas.
authors: Yair
authors: Y
authors: Lotan
authors: Department of Urology, Hospital Motol, Second Faculty of Medicine, Charles University, Prague, Czech Republic.
authors: Marko
authors: M
authors: Babjuk
authors: Department of Urology, Medical University of Vienna, Vienna General Hospital, Vienna, Austria.
authors: Michela
authors: M
authors: de Martino
authors: Department of Urology, Weill Cornell Medical College, New York-Presbyterian Hospital, New York, New York.
authors: Douglas S
authors: DS
authors: Scherr
authors: Department of Urology, Medical University of Vienna, Vienna General Hospital, Vienna, Austria; Department of Urology, Weill Cornell Medical College, New York-Presbyterian Hospital, New York, New York. Electronic address: sfshariat@gmail.com.
authors: Shahrokh F
authors: SF
authors: Shariat
mesh_terms: D000017:ABO Blood-Group System; D002295:Carcinoma, Transitional Cell / Q000097:blood* / Q000473:pathology*; D015331:Cohort Studies; D018450:Disease Progression; D006801:Humans; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000097:blood / Q000453:epidemiology; D012189:Retrospective Studies; D016896:Treatment Outcome; D001749:Urinary Bladder Neoplasms / Q000097:blood* / Q000473:pathology*
chemical_list: D000017:ABO Blood-Group System
keywords: ABO blood-group system; carcinoma; disease progression; local; neoplasm recurrence; urinary bladder