ABO blood group is a predictor of survival in patients undergoing surgery for renal cell carcinoma

Study Type – Prognosis (cohort series) Level of Evidence 3a What's known on the subject? and What does the study add? Some evidence suggests that ABO blood type may be a risk factor for cancer incidence and prognosis. For example, a large study recently discovered an increased incidence of pancreatic cancer in patients with non‐O blood type; however, it is not known whether blood group correlates with outcomes in patients with RCC. We found a significant and independent association between ABO blood group and overall survival in patients undergoing surgery for locoregional RCC. Specifically, we identified non‐O blood type as a predictor of mortality. OBJECTIVE • To determine whether ABO blood group is associated with survival after nephrectomy or partial nephrectomy for renal cell carcinoma (RCC). PATIENTS AND METHODS • We conducted a retrospective cohort study of 900 patients who underwent surgery for locoregional RCC between 1997 and 2008 at a single institution. • Covariates included age, gender, race, American Society of Anesthesiology Physical Status, preoperative anaemia and hypoalbuminemia, tumour characteristics, lymph node status, procedure performed, transfusion status and ABO blood group. • Primary outcomes were overall (OS) and disease‐specific survival (DSS). • Univariable survival analyses were performed using the Kaplan–Meier and log‐rank methods. Multivariable analysis was performed using a Cox proportional hazards model. RESULTS • The 3‐year OS estimate was 75% (95%CI 70–79%) for O blood group and 68% (95% CI 63–73%) for non‐O blood group (P= 0.072). The 3‐year DSS was 81% (95% CI 76–85%) for O blood group and 76% (95%CI 71–80%) for non‐O blood group (P= 0.053). • In the multivariable analysis for OS, non‐O blood type was significantly associated with decreased OS (HR 1.68, 95%CI 1.18–2.39; P= 0.004) but not DSS (HR 1.53, 95%CI 0.97–2.41; P= 0.065). CONCLUSION • These data suggest that ABO blood group is independently associated with OS in patients undergoing surgery for locoregional RCC. ABO blood group has not been previously recognized as a predictor of survival in RCC.