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.
Keywords: Anemia; Kidney; Neoplasm by histologic type; Prognosis; Renal cell carcinoma.
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