ABO Blood Group and Rhesus Factor Are Not Associated with Outcomes After Radical Cystectomy for Non-metastatic Urothelial Carcinoma of the Bladder

Aim: To investigate the role of ABO blood group and Rhesus factor as a predictor of outcome in patients undergoing radical cystectomy (RC) for non-metastatic urothelial carcinoma of the bladder. Materials and Methods: Data of 463 consecutive patients treated with RC between 1988 and 2003 were retrospectively analyzed. The effect on recurrence-free survival, and cancer-specific and overall mortality were assessed using the Kaplan-Meier and multivariable Cox regression methods. Results: Overall, 185 (41.3%), 190 (42.4%), 46 (10.3%) and 27 (6%) patients expressed O, A, B and AB phenotypes, respectively; 65 (14.5%) were Rhesus-negative. Median follow-up was 14.2 years (interquartile range=10.2-17.1 years). No individual blood group was associated with any clinicopathological characteristics whereas Rhesus-positive patients had a higher rate of pT4 disease (11% vs. 22%; p=0.02). ABO blood groups were not associated with outcomes. Rhesus-positive patients had an increased risk of shorter recurrence-free survival, and of cancer-specific and overall mortality compared to Rhesus-negative patients (all p<0.03). In multivariable analyses that adjusted for the effects of standard characteristics, this association disappeared. Conclusion: The results of our study showed that neither ABO blood group nor Rhesus factor are associated with oncological outcomes. The clinical relevance of blood groups and Rhesus factor in bladder cancer remains questionable.