title: Prognostic impact of preoperative anemia on non-muscle-invasive bladder carcinoma treated with GreenLight laser vaporization.
abstract: In this study, we aimed to evaluate the impact of preoperative anemia (PA) on oncological outcomes among patients with non-muscle-invasive bladder cancer (NMIBC) treated with GreenLight laser vaporization of bladder tumor (PV-BT). Between January 2010 and December 2015, 407 patients with NMIBC who underwent PV-BT surgery were stratified into normal and anemia groups based on the World Health Organization classification (anemia cutoff value: hemoglobin level, <13.0 m g/dL in men and <12.0 mg/dL in women). The Student's t test and chi-square test were performed to assess the effects of PA on clinical and pathological characteristics of patients with NMIBC. The Kaplan-Meier method was used to investigate the influence of PA on oncological survival outcomes. Before PV-BT, 139 patients (34.2%) were anemic. No significant differences in age, sex, smoking habit, tumor size, focality, grade, and stage were found between the anemia and normal groups. At a median follow-up period of 32.5 months (range, 8-60 months), 74 patients (18.2%) had urothelial recurrence, 30 (7.4%) died from any cause, and 21 (5.2%) died from bladder cancer. In the Kaplan-Meier analysis, preoperative anemia was significantly associated with decreased cancer-specific survival (CSS) and overall survival (OS) of the patients with NMIBC. However, recurrence-free survival (RFS) showed no statistically significant difference between the PA and normal groups. The preoperative anemic patients with NMIBC who underwent PV-BT surgery had worse CSS and OS. PA can be a useful and cost-effective prognostic marker in the clinical practice for NMIBC treatment.
authors.affiliation: Department of Urology, Tianjin Union Medical Center, No. 190 Jie-yuan Road, Hong-qiao District, Tianjin, China.
authors.forename: Fei
authors.initials: F
authors.lastname: Luo
authors.affiliation: Department of Urology, Tianjin Union Medical Center, No. 190 Jie-yuan Road, Hong-qiao District, Tianjin, China.
authors.forename: Ya-Shen
authors.initials: YS
authors.lastname: Wang
authors.affiliation: Department of Urology, Tianjin Union Medical Center, No. 190 Jie-yuan Road, Hong-qiao District, Tianjin, China.
authors.forename: Yan-Hui
authors.initials: YH
authors.lastname: Su
authors.affiliation: Department of Urology, Tianjin Union Medical Center, No. 190 Jie-yuan Road, Hong-qiao District, Tianjin, China.
authors.forename: Zhi-Hua
authors.initials: ZH
authors.lastname: Zhang
authors.affiliation: Department of Urology, Tianjin Union Medical Center, No. 190 Jie-yuan Road, Hong-qiao District, Tianjin, China.
authors.forename: Hong-Hong
authors.initials: HH
authors.lastname: Sun
authors.affiliation: Department of Urology, Tianjin Union Medical Center, No. 190 Jie-yuan Road, Hong-qiao District, Tianjin, China. lijian_2016tj@163.com.
authors.forename: Jian
authors.initials: J
authors.lastname: Li
mesh_terms: D000368:Aged; D000740:Anemia / Q000150:complications*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D053685:Laser Therapy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009132:Muscles / Q000473:pathology*; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000473:pathology; D011300:Preoperative Care; D011379:Prognosis; D001749:Urinary Bladder Neoplasms / Q000150:complications* / Q000473:pathology / Q000601:surgery*
keywords: Anemia; Bladder cancer; Hemoglobin; Laser